Big Data on the Impact of Adverse Childhood Experiences

Big Data on the Impact of Adverse Childhood Experiences … conducted a systematic review and meta-analysis of studies from Europe and the USA …

You use your platforms and voices to both raise awareness and enforce change and be change, and I feel deeply that there is nothing more respectable one with such a platform can do. — Lady Gaga

The original groundbreaking Adverse Childhood Experiences (ACE) Study, Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults (1998) led to an expanding awareness of the suffering, cost and burden illness wreaked by childhood abuse and neglect.

Looking at data from from over 17,000 patients in a California HMO, they found that patients with greater than 4 ACEs were at increased risk for a variety of serious problems: “4- to 12-fold increased health risks for alcoholism, drug abuse, depression, and suicide attempt; a 2- to 4-fold increase in smoking, poor self-rated health, ≥50 sexual intercourse partners, and sexually transmitted disease; and a 1.4- to 1.6-fold increase in physical inactivity and severe obesity.”

Subsequent research has looked at various other aspects of the negative effects of ACEs, showing negative effects on educational achievement, physical and mental health outcomes and biological markers of disease, and other negative effects on individuals, families, communities and society.

A Global Scourge

ACEs represents a chronic epidemic which hurts the entire planet. Not only that, ACEs are perpetrated by our species against itself, as adults both permit and directly enact abuse and neglect on children. Those children of course grow up to be shaped by their developmental experiences, and so the cycle repeats.

We can study specific outcomes, economic costs, health impact, biological pathways, effects on the healthcare system, and so on. At this time, it is possible only to speculate about the overall impact on our society.

Consider the evolutionary impact of generations of ongoing trauma to children. It shapes the very essence of our species, defining who we are. It shapes culture and mind, and must impact how we make collective decisions, how we respond to threats such as the climate crisis and gun violence, what we expect from one another — and how we must position ourselves defensively to protect ourselves from one another.

I want you to feel the fear I feel every day. And then I want you to act. I want you to act as you would in a crisis. I want you to act as if our house is on fire. — Greta Thunberg

In a world where an estimated 1 billion childrenaround the globe experience violence — let alone famine, disease, a lack of sanitation, substandard education, and so on (Hillis, Mercy, Amobi and Kress, 2016). How do we live with this?

The Big Picture

Because much of the research on ACEs has been a variety of smaller and larger studies looking at different outcomes across many different populations, a large-scale consolidation of the existing data is in order. To accomplish this, as reported recently in The Lancet, Public Health, researchers Bellis, Hughes, Ford, Rodrigues, Sethi, and Passmore (2019) from the World Health Organization (WHO) conducted a systematic review and meta-analysis of studies from Europe and the USA looking at ACEs outcome data.

In order to conduct a study like this, scientists first identify all the possible research to include, and through a process of painstaking elimination cone down on only the high quality, non-overlapping studies. They then apply statistical techniques to pool the data to identify common measures, or align data when different measures have been used, in order to calculate the “relative risk” of various outcomes as a function of how many ACEs a given person has experienced.

For this study, they found 4387 articles, and included studies measuring ACEs with at least 1000 people. Eliminating studies which they could use, for example with too few participants, data from earlier studies, poor research methods, they ended up with 23 high-quality articles to analyze, including 11 studies in Europe and 12 in North America, mainly the United States.

The studies ranged in size from 1,500 to 978,647 people, and two looked were population studies following individual from birth. The ACEs reviewed included child emotional, physical and sexual abuse, exposure to violence in the home, break up of the family, and drug abuse, mental illness or crime within the household. The full ACEs scale is at the end of this piece, and may be triggering.

Dire Findings

Among the 1,514,254 people in the European sample, 23.5 percent had one ACE, and 18.7 percent had two or more. Among the 121,341 in North America, 23.4 percent had one ACE, and 35 percent had two or more. North America, primarily the USA, had nearly double more severe ACEs than the European group.

For both groups, illicit drug abuse was most strongly associated with ACEs, among the factors studied. Illicit drug abuse was 34.1 percent more common in Europe and 41.1 percent in North America, with annual financial losses of $46 billion and $168 billion, respectively as a result of direct and indirect costs.

About 25 percent of harmful alcohol use in both regions was from ACEs, adding up to $143 billion and $73 billion, respectively, in Europe and North America. ACEs was associated with 18.2 percent and 23.7 percent, respectively of the incidence of cigarette smoking, costs of

$165 billion and $160 billion. Rates of obesity due to ACEs was comparatively low, but costs added up to $40 billion and $65 billion.

For health outcomes, ACEs were most highly connected with mental illness, accountin for an estimated 30 percent of anxiety disorder and 40 percent of depression, with a total price tag of $51 billion and $82 billion in Europe and North America. After mental health, lung disease was the next most impacted by ACEs, from 20-25 percent across both continents, ringing up costs of $146 billion across both regions. While cardiovascular disease and cancer were relatively less associated with ACEs, the costs were very high due to the nature of these illnesses.

Bellis, Hughes, Ford, Rodrigues, Sethi, and Passmore (2019)
ACEs Findings
Source: Bellis, Hughes, Ford, Rodrigues, Sethi, and Passmore (2019)

A Vicious Cycle

The majority of the costs were from two or more ACEs, as compared with only one ACE. The negative synergy of having more than one ACEs is massive.

For example, for more ACEs with alcohol abuse, 63 percent of the cost came from those with two or more ACEs. For anxiety, 96 percent of the cost came from those with two or more ACEs.

The total annual costs from ACEs tallied were $581 billion in Europe (2.67 percent GDP) and $748 billion in North America (3.6 percent GDP). In Europe, these 77 percent of the cost came from two or more ACEs, and 82 percent in North America.

The study authors calculated than even a 10 percent reduction in the rates of two or more ACEs would translate to an annual saving totaling $105 billion across both regions, equivalent to a total reduction 3 million DALYs (Disability-Adjusted-Life-Years, a measure of global burden of disease from sickness and death). These are profound findings.

What Can We Do?

It’s a sad fact of our world that so many children (and adults) are exposed to violence, trauma, abuse and neglect. The cost in terms of dollars is startling, and the fact that much of this suffering is from commercial sales of harmful substances is a collective shame. Adverse childhood experiences, in principle, should be easy to prevent. Doing so would prevent illness and suffering, and free up financial resources for better use than damage-control for species-specific self-inflicted wounds.

However, it is not so simple. The impact of intergenerational transmission of trauma, the impact of the social determinants of illness, the lack of systems to divert resources to areas in need, the collective moral challenge we are facing, our addiction to war and aggression, and other factors means it is not appropriate to blame individuals for the high rate of ACEs we see. Human beings seem to be the only animals who do this kind of thing on such a grand scale. We don’t truly know why, but this is a question of ever-more-pressing urgency.

Complacency Is Lethal

If there is a call to action, it is to first raise awareness. With collaboration, compassion and reason, and especially by empowering and educating the younger generations stuck with this terrible bill, can we hope for a different kind of world, and a different kind of human being.

Future research will further define the scope of the problem we are facing. Importantly, identifying high-value areas for intervention and testing the impact of interventions is needed to direct limited resources to the highest value targets.

Diverting resources from destructive behaviors to constructive behaviors is a heavy lift for the capitalist mindset, indeed for any mindset perhaps. But even the most “greedy” capitalist mindset could be swayed by a deep understanding of the data. We see this, for instance, as some insurance companies are finally persuaded to pay for mental health treatment… but only as they come to see that doing so saves them billions in the future. Long-term thinking is sorely lacking.

Preventing ACEs is of urgent importance, as is mitigating the negative impact of ACEs currently, in terms of substance and alcohol abuse, mental illness, physical health outcomes, and the cost to society. Understanding whether ACEs are also associated with the problems facing society, including climate issues, mass violence, and in general impaired collective decision-making, would be helpful for raising awareness, changing attitudes and catalyzing change.

ACEs Questionnaire – Trigger Warning

public domain/not copyrighted
To derive ACES score
Source: public domain/not copyrighted

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Elon Musk Teases November Release Of The Pickup Truck

Elon Musk, the CEO of Tesla has once again been up to his social media antics. In the past as well Musk has been known to use social media as an …

Elon Musk, the CEO of Tesla has once again been up to his social media antics. In the past as well Musk has been known to use social media as an effective tool to expand the base of his followers as well as give out news pertaining to the company as well as the products it is about to launch.

Once again, while replying to random tweets he dropped a major hint at when his next, an innovative pickup truck will be out in the market.

On Saturday, when a user of the social media platform Twitter tweeted to Elon Musk to ask about an update on the revelation of its pickup trucks, Musk replied by tweeting to him and saying that they will be out most probably by November.

Previously, Musk had given a hint at that the company will be revealing the pick-up truck which it calls ‘’Cyberpunk Truck’’ in the month of June however no such revelation took place in that month.

The plan for revealing it in the summer were in place till very recently, in fact in the annual shareholder meeting June, a teasing debut was made for the Cyberpunk Truck which offered a close up which was indistinct and showed what people speculated to be its LED running light along with the then promise of unveiling it in the summer.

In the same presentation Elon Musk had said that the Semi truck from Tesla will be arriving by the end of the year 2020 and also that the compact SUV of Tesla, the Model Y will be available too by the end of the year 2020.

About the pickup truck it said that it will be something similar to a sci-fi movie.

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Diane Sorensen
Content Writer & Editor AtIndustry News Works

After studying the Astronomical Sciences, Diane continued to write about space and the universe. Because of her passion and curiosity about topics related to science and astronomy, as well as his understanding of scientific terminology, she is responsible for the coverage of the science section. She is very enthusiastic in studying missions, launches, and discoveries of the space. Her knowledge about the Space domain is of great help to others too.

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What went wrong at Uber

A video of Uber’s then-CEO, Travis Kalanick, berating one of his company’s drivers for not “[taking] responsibility for [his] own sh*t.” Losing $1B in a …

If Uber’s 2017 were a ride across town, it would get 1 star.

You’d be hard-pressed to dredge up a worse 12-month stretch in recent corporate history. It seemed like every week, the rideshare giant would grapple with a flat tire:

  • Allegations of systemic sexual harassment and sexism.
  • Losing 400k customers in the wake of the #deleteuber hashtag on Twitter.
  • Getting called out by their own investors for having a “toxic” culture.
  • A federal lawsuit over the IP theft of self-driving car technology.
  • A video of Uber’s then-CEO, Travis Kalanick, berating one of his company’s drivers for not “[taking] responsibility for [his] own sh*t.”
  • Losing $1B in a largely unsuccessful bid to compete in China, and…
  • Kalanick’s ultimate resignation.

Mike Isaac, a reporter at TheNew York Times, was along for the whole ride — and he’s chronicled it all in his new book, Super Pumped: The Battle for Uber.

I recently spoke with Isaac about the company’s tumultuous journey to the top, and how it serves as a cautionary tale for the tech industry at large. The transcript below has been lightly edited for clarity and length.

Left: Mike Isaac (Helena Price Hambrecht); Right: Isaac’s new book

Can you tell me a bit about the scope of reporting that went into this book?

I first started following Uber in 2010, when it was still called UberCab. It’s been nearly 10 years in the making of being around this company, watching it grow and change, and seeing how [SIlicon Valley] evolved around it.

Why is Uber’s saga important to rehash right now?

We’re at a very interesting and new time in technology. There was an inflection point in 2016-2017 where people really started to question how tech shaped their lives. The election of Trump called into question how these big platforms, like Facebook and Twitter, might be manipulated.

In the wake of that, Uber stepped in and became this avatar for everything that seemed to be wrong with tech.

There’s the Wolf of Wall Street-level excess in terms of wealth and opulence — from raising enormous amounts of money to spending $25m on a single [employee] party in Vegas in 2015. There’s the conversation about how they treat drivers, and the divergence of different class structures — the people who use the service, and the “underclass” who serves them. Then, there’s the all the bad behavior that results from growing at any cost.

The book is about Uber, but it’s also kind of not about Uber. It’s more about the way that perverse incentives can make good people do bad things, and make bad people do even worse things.

Kalanick gives a presentation in China in 2015 (Visual China Group via Getty Images)

Let’s talk about the “growth or die” mentality that Uber, like many startups, adhered to. What darker paths did this lead Uber down?

In 2017, there was a rash of extreme violence in different countries [where Uber’s service was expanding].

Outside of Mexico City, in cartel country, there were drivers being killed. In Brazil, drivers were getting robbed and murdered. Some of these instances were the direct result of not building enough safeguards into the app to verify riders’ identities. But it was really about signing people up with as little friction as possible, as fast as possible.

The thing they didn’t realize — and this applies to most tech companies — is that parachuting into markets with their own cultural and socioeconomic factors and dropping a new thing in can have a lot of different consequences. Some of those are good, like allowing people to earn more than they did before. Others are wildly crazy, and wrong, and bad.

Uber’s growth strategy also relied heavily on breaking rules. As you reported, they’d launch in a new city and just straight up ignore all the local laws. One source even told you there was an attitude that “the law isn’t what’s written; it’s what’s enforced.”

Right. Uber saw themselves as a new entry into an inherently unfair system that was set up for [the taxi industry] and wasn’t open to competition. They thought that this system didn’t allow room for others to break in; it was like, the rules don’t really matter when they’re bullshit to begin with.

[Uber’s] response to that was not to change the system from within but to blow up the system and try to ‘invade’ cities. Their strategy was to get to the point where their service would become so indispensable that the legislature would just have to deal with them. Their disruption would lead to new laws. Most of the time it worked.

I do wonder what entrepreneurs will take away from that. Maybe they’ll try to replicate it. Hopefully not.

A protestor holds up a sign outside of Uber’s San Francisco headquarters in 2019 (JOSH EDELSON/AFP/Getty Images)

Uber, of course, did a lot of things wrong. But you write that their story shows both the best and the worst of Silicon Valley. Can you parse out this duality a bit?

It’s too easy to say tech is evil, or to become a Luddite and want to destroy it all.

A lot of the things these companies build can be used as a positive force. I just think you really have to look hard at the negative influence to help curb that, whether that’s people being killed, or drivers having to sleep in their cars [due to inadequate pay]. Are we willing to live with these things as a cost of doing business, or should we work together to figure out a better way of doing things?

Right now we’re in an era of regulation. So we’re starting to rein in the unfettered power of tech.

What did the term “super pumped” mean to employees there?

Being “super pumped” was actually one of the values employees were evaluated on for their official job reviews. Managers would review them on their level of being super pumped. Kalanick wanted everyone to be “super pumped”… being super pumped gave you super powers.

It embodied what their mentality was — this sort of bro-ish ideal of excitement and a willingness to take on everyone.

Kalanick also loved the word “hustle.” In fact, “Always be hustlin’” was one of his 14 core values. What did this word mean to the company culture?

At Uber, people would get emails at all hours of the night. If you didn’t respond at midnight, you’d get [flak]. People I talked to said there was very little work-life balance.

My colleague, Erin Griffith, wrote a really good feature on “hustle culture,” and this idea that you always need to be working.

Values via Uber/YouTube; graphic by The Hustle

You write in the book that Kalanick hated to lose. Winning wasn’t enough; he had to crush his competition. Do you see him as a Machiavellian figure?

There were a few comparisons that kept coming up when I talked to people [about Kalanick]: Machiavelli. Sun Tzu. Some people called him a Trumpian figure, in the sense that he was great at creating his own reality.

But Machivelli really fits. [Kalanick] had a very cynical, dry, almost militaristic view of the world — a kind of moral relativism predicated on the idea of winning and conquering.

Who where Kalanick’s chief enablers?

He tended to hire people who worshipped him or idolized him. Investors just wanted to make money, so they didn’t really care if the culture was terrible.

Investors also contributed to a “cult of the founder” in Silicon Valley: They gave celebrity CEOs free rein to do as they pleased. Was this mentality partly to blame for Uber’s eventual leadership problems?

Investors certainly reinforce this cult of the founder.

They’re looking for that next Zuckerberg or Spiegel — a wünderkind who can build the next billion-dollar startup in their dorm room while eating bowls of ramen. It’s a very attractive mythology. The idea of fetishizing this boy genius figure was common for a very long time; now, we’re nearing the limits of that.

So much can go wrong when you give one person unfettered control of a whole company — really, control over changing a lot of what the world looks like. And a lot of it starts at the investment level.

Do you think a certain ruthlessness is necessary in building a huge tech company like Uber? Is the power inherently corrupting?

The usurper always ends up being the dominant culture. The people who come in wanting to free society from the bondage of power end up having the power — and maybe abusing that power.

One of [Kalanick’s] flaws was the inability to recognize when he won, when he was that great company. He viewed Uber from the lens of a scrappy startup, but then one day, he was the guy at the top. And tech leaders will do what’s necessary to stay at the top.

Kalanick leaves a San Francisco courthouse in 2018 (Elijah Nouvelage/Getty Images)

There are so many shocking anecdotes in your book, from Uber execs expensing strip club visits to Kalanick turning down a $40m investment from Jay-Z. Of all the things you reported on, what shocked you the most?

The scale of Uber’s fraud in China was insane to me.

I talked to sources who told me that literally half of all dollars in some cities were going to completely fraudulent rides from scammers, who ended up building a huge crime ring around Uber. The lengths to which they went to to build some of these systems was staggering.

I imagine investors would not be too happy if they knew their money was going straight into the incinerator, or the pockets of criminals in China. In Southeast Asia, [Uber] went from 70-something market share to 20 and burned through piles of money.

It’s been two years now since Kalanick was ousted. How have things changed at Uber since then?

It’s going to take them a while to repair their reputation — if they even can. They’re still reconciling with all the things in their past.

Super Pumped: The Battle for Uber is available on Amazon now.

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A dangerous IDNYC overhaul: Don’t equip this card with financial technology chips

The city wants to partner with a third-party firm to add a financial technology chip to the cards, saying this will help the very same low-income New …

We are talking about the most vulnerable New Yorkers — the homeless, the homebound, the elderly, the young, veterans, immigrants, and members of the LGBTQ community. These New Yorkers and those who serve them use the card because they trust it, knowing the city is required by law to expunge their personal information once they obtain it.

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Healthcare Robotics Growth Opportunities, Sales, Revenue, Industry Analysis and Forecasts 2026

Ekso Bionics Holdings Inc … Irobot Corporation … The key Healthcare Robotics market players with their business overview, marketing strategies, …

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