In DepthPUBLIC HEALTH

Screen for childhood trauma triggers debate

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Science  31 Jan 2020:
Vol. 367, Issue 6477, pp. 498
DOI: 10.1126/science.367.6477.498

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Summary

On 1 January, California became the first U.S. state to screen for adverse childhood experiences (ACEs)—early life hardships such as abuse, neglect, and poverty, which can have devastating health consequences in later life. The $160 million initiative applies to children and adults on Medi-Cal, California's insurance for low-income people. Health care providers who complete 2 hours of online training are encouraged to screen adults and children up to age 18 for ACEs, with a questionnaire that includes 10 categories of ACEs, such as domestic violence, neglect, and substance abuse. The project is not just a public health initiative, but a vast experiment. State officials aim to cut the health impacts of early life adversity by as much as half within a generation. But critics say the health benefits of screening are unproven, and it could create demand for services the state cannot provide.

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