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Nadine Burke Harris: The toxic stress of detention can dramatically alter kids’ lives

Video: Children growing up with toxic stress from abuse or neglect are more likely to have lifelong health problems. Migrant children being separated from their parents, students surviving a school shooting, kids growing up in homes with substance abuse or mental illness are all at risk. But Nadine Burke Harris, California’s surgeon general, says there is hope. (The Washington Post)

Children in dirty clothes who haven’t been bathed in days. Eight-year-olds caring for toddlers out of necessity. Kids deprived of the safe, stable and nurturing care that’s fundamental to their health and well-being.

As a pediatrician who has spent my career working to address childhood trauma, I've unfortunately seen it all. And I've had to make my share of reports to Child Protective Services. But whom do we call to report the mistreatment of children by the federal government?

Over the past few weeks, we've seen report after report about the alarming conditions that children are experiencing in our federal detention centers. These conditions aren't just heartbreaking; they're dangerous to a child's health. And I'm not talking about germs.

You don't have to be a doctor to recognize that the forcible separation of a child from her parent is deeply traumatic. But what the science tells us is that when kids experience trauma, without the buffering support of a nurturing caregiver, it can change their developing brains and bodies and cause serious consequences.

Research from the Centers for Disease Control and Prevention, Kaiser Permanente and other expert institutions has shown that severely traumatic events, or adverse childhood experiences, such as being forcibly separated from a parent or caregiver, substantially increase the risk for negative physical and psychological outcomes, both in the short term and later in life.

Here's why: When any one of us experiences something traumatic, our brains and bodies activate our fight-or-flight response that leads to the production of high levels of stress hormones. They stimulate our hearts to beat stronger and faster, raise blood pressure and blood sugar, activate our immune system, and alter brain functioning.

That's great if you're in the forest facing a wild animal and you're built to run, but science shows that too many stress hormones can lead to serious damage. Children require the nurturing care of a trusted adult to shut off the stress response. Without this, kids are at high risk of long-term changes in brain structure and function, weakening of the immune system, and impairment of hormonal levels.

These changes are what is now recognized by the American Academy of Pediatrics as toxic stress response. Toxic stress increases the chances that individuals will develop asthma and infections in childhood and develop cardiovascular disease, diabetes, substance dependence and depression in adulthood - cutting their life expectancy short by decades.

This is about medical science, not politics. Republicans and Democrats alike have called for more humane treatment of children at our border. Former first lady Laura Bush's eloquent opinion piece last year rightly cited that individuals of Japanese descent who were interned during World War II were twice as likely to develop cardiovascular disease or die prematurely as those not interned.

The CDC has called for using data about the importance of safe, stable and nurturing relationships and environments in our policies and actions, and the American Academy of Pediatrics strongly warned that our government should "eliminate exposure to conditions or settings that may retraumatize children, such as those that currently exist in detention, or detention itself."

Yet our immigration policies continue to forcibly separate children from their caregivers and place them in conditions known to harm their healthy development. This practice of injecting unnecessary and preventable suffering into the lives of migrant children and their families must be stopped.

The physical toll placed on these young, growing bodies and brains comes at a tremendous cost to the individuals, their families and communities, and ultimately, to our national conscience. Regardless of what one thinks about immigration, there's one price no child should have to pay: a shortened life.

Dr. Nadine Burke Harris, an alumna of UC Davis, is a medical doctor focused on Adverse Childhood Experiences (ACEs) and toxic stress and how that informs health later in life in her work at Center for Youth Wellness on March 6, 2018. She's the author of a new book and founder of this center.

Nadine Burke Harris is the surgeon general of California.