The Fort Worth City Council, at Tuesday's work session, was given a presentation on the ACEs Task Force: Supporting Safe, Healthy, and School-Ready Children. ACEs is an acronym for Adverse Childhood Experiences study.

The Cook Children's Medical Center promise, presented to the council and mayor, is "Knowing that every child’s life is sacred, it is the promise of Cook Children’s to improve the health of every child in our region through the prevention and treatment of illness, disease and injury."

The presentation was given by Rick Merrill, president and CEO, Cook Children’s Health Care System; along with Anu Partap, MD, MPH, ACEs Task Force Chair and Physician Director, Center For Prevention Of Child Abuse and Neglect Cook Children’s.

"I think it's groundbreaking work we're doing here," Merrill said.

"It is humbling work," Partap said. "Learning means listening, and I've learned more than I've learned in 20 years as a physician."

Tarrant County ACEs Task Force works with over 60 partners and advisors in an effort to prevent and reduce adversities prenatally to age 5 to improve health, safety and school readiness. The Task Force leadership includes:

*Chair, Cook Children’s Health Care System.

*City of Fort Worth, Mayor Betsy Price and City Council Office

*Fort Worth City Manager’s Office.

*Office of Tarrant County Judge Glen B. Whitley.

*Office of Tarrant County Commissioner Roy Charles Brooks.

*JPS Health Network.

*Morris Foundation.

Adverse childhood experiences, first studied in 1998, are a set of experiences before the age of 18 that are associated with:

*High risk behaviors.

*Chronic disease.

*Reduced quality of life, even into adulthood.

Samples of questions asked to adults, before your 18th birthday did a parent or other adult in the household often or very often… Swear at you, insult you, put you down, or humiliate you? Act in a way that made you afraid that you might be physically hurt? Did a parent or other adult in the household often or very often… push, grab, slap, or throw something at you? or Ever hit you so hard that you had marks or were injured? Did an adult or person at least five years older than you ever touch you in a sexual way or attempt to have a form of sex with you?

Studies show that nearly 40% of adults across demographics experience two or more ACEs before the age of 18, abuse, neglect, and household dysfunction. Over a four-year span from 2011-14, a breakdown of frequencies included:

*Abuse and neglect: 10%-34%.

*Parental substance abuse: 28%.

*Intimate partner violence: 18%.

*Parental mental Illness: 17%.

*Incarcerated family member: 8%.

Examples of common childhood conditions associated with living with abuse, neglect, and parenting/household struggles include infant mortality, developmental delays, poorly controlled asthma, mental health concerns, truancy/absenteeism, and more.

In adulthood, ACEs are associated with high-risk behaviors, chronic disease, and lower life potential.

Science suggests the link between adversity and child and adult outcomes includes:

*Physical abuse

*Sexual abuse

*Neglect

*Parent with addiction

*Domestic violence

*Parent with mental illness

*Parent who is incarcerated

*Divorce

*Housing instability

*Food insecurity

Lack of a nurturing caregiver during early years triggers abnormal

neurophysiological stress response, which impairs safety, health, learning, and life potential.

The long-lasting effects of ACEs can lead to obesity, diabetes, heart disease, STDs, suicide attempts, and even broken bones. Teenage and adult challenges can include smoking, alcoholism, drug use, while lower graduation rates and academic achievement, along with lost time from work, are also effects.

"When you take a look at the kind of research that goes on at Cook Children's, it really is a gem in the city," District 5 Councilwoman Gyna Bivens said.

Then, Bivens picked up a copy of a survey given to each council member, and added, "Take a look at it. You may find that you too have an ACE from the past.

"This is really tugging at my heart."

ACEs Task Force focuses on opportunities to prevent safety, health, and learning problems before age 5 to prevent negative adult outcomes. They identify strategies to break the cycle.

Fort Worth-focused strategies include:

*Exploring low-cost transportation

*Conducting a Cook Children’s Early Childhood ACEs Pilot with FWISD, Fort Worth Housing Solutions, JPS.

*Launching early childhood parenting “Connecting Generations” Coalition.

Tarrant County-wide strategies include:

*Promoting 25 systems-level strategies to reduce ACEs.

*Launching Tarrant Cares texting feature.

*Training systems of care to prevent ACEs.

*Promoting access to primary care.

"This is cradle-to-career important. There isn't one of us in this room who hasn't had at least something shape them," Mayor Betsy Price said. "This is truly the start of something great."

Then, Price challenged the council, saying, "We each have a bully pulpit to move this forward, and shame on us if we don't."

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