Now is the Time: Building Pathways to Resilience Across the Country

If there is any silver lining to the COVID-19 pandemic, it is that talking openly about the stress and mental health challenges so many of us experienced is no longer reserved for the therapist’s couch. Our collective experience with COVID-19 has helped normalize a topic that has been historically stigmatized, downplayed, and even denied in our families, schools, communities, and workplaces. The word “anxiety” has become a household term and the physical and emotional manifestations of stress are now recognized as determinants of long-term health and well-being. We know that these stressors have had more acute implications for low-income individuals and communities of color.The COVID-19 pandemic also amplified the many inequities that exist across the country. According to a recent study, more than 140,000 U.S. children lost a primary or secondary caregiver to COVID-19 – more than two-thirds of these children are from communities of color. Reports of decreases in economic stability and school performance, as well as increases in domestic violence and substance use, have also disproportionately affected lower-income communities. Without access to family, friends, school, and community and absent other “buffering supports,” exposure to adverse childhood experiences (ACEs), trauma, and toxic stress increases the risk of serious health conditions and premature death. Positive relationships and experiences are critical to one’s ability to build resilience.

Becoming ACEs Aware

When Aurrera Health Group began supporting California’s first Surgeon General, Dr. Nadine Burke Harris, in realizing her vision for the California ACEs Aware initiative, we could not have known just how important and timely our work was about to become. Dr. Burke Harris advocated for nearly a decade that ACEs and toxic stress should be recognized as a public health crisis and 2020 brought this point into even greater focus.For more than two years, Aurrera Health has supported the ACEs Aware initiative’s free online training, produced more than 20 educational webinars, and provided technical assistance to community grantees, clinical teams, and other stakeholders on ACEs, trauma-informed care, and prevention and treatment of toxic stress. We developed materials like The Trauma-Informed Network of Care Roadmap and the ACE Screening Implementation How-To Guide to provide actionable resources for clinicians and community organizations to work together to prevent, treat, and heal trauma and toxic stress.Our work in California also provided valuable opportunities to interact and share information with national leaders in the fields of adversity and trauma, prevention, and resilience. While there are indeed a range of promising initiatives underway in states and communities, we believe there is an urgent need for an organizational home to facilitate a cohesive national strategy focused on promoting cross-sector, trauma-responsive policies and programs.

Now is the Time

The more we spoke with experts, foundations, and state leaders about the need for a national cross-sector initiative, the more we realized that Aurrera Health Group is right for the job. Our mission-driven team has decades of experience designing and implementing major policies and programs at the federal and state levels. We understand the importance of collaboration and relationship-building within state agencies, and we appreciate the myriad of state fiscal and policy dynamics that are always at play. We are also deeply committed to ensuring that policymaking reflects the needs and culture of the populations and communities being served.As such, we are stepping out of the traditional consulting role to independently launch a new initiative – Pathways to Resilience. We believe this initiative can play a critical role by raising awareness about ACEs, trauma, and toxic stress; building and promoting cross-sector strategies for preventing and addressing adversity and trauma; advancing understanding of the importance of positive relationships and experiences in building resilience; and ultimately improving our nation’s health.Pathways to Resilience is designed with state policymakers and agency leaders in mind. As lifelong students of Medicaid policy, we know there is no one-size-fits- all solution, but there are a multitude of practical, scalable approaches that can make a difference.Our goals and objectives for Pathways to Resilience are to:

• Recognize and normalize conversations about the impact of adversity, trauma, and toxic stress on overall health and well-being;

• Promote collaboration across sectors to invest in evidence-informed strategies that support prevention, resilience, treatment, and healing through a culturally competent and equitable lens;

• Build and advance understanding of the critical role of positive experiences and relationships in prevention, with emphasis on practical approaches to support healing; and

• Prevent and mitigate the systemic and intergenerational transmission of adversity, trauma, and toxic stress.

Pathways & Partnerships

Pathways to Resilience will serve as a convenor of state leaders, policymakers, and administrators and offer a forum to collaborate and share best practices with colleagues across the country. We will draw on the wisdom of a Steering Committee of Governors’ First Spouses – chaired by Delaware First Lady Tracey Quillen Carney – who have committed to help champion this work.We are also building an Advisory Committee of nationally recognized experts in health, education, justice, early childhood, and social services. The committee will help inform the discussion topics for a monthly Learning Network webinar series. This Learning Network will serve as a vehicle for sharing promising practices as well as for exploring different approaches to developing trauma-responsive policies and programs. Pathways will host a website and a blog that will serve as a centralized home for sharing the latest research, resources, and strategic considerations for states.Our partners will be integral to our success. The ACE Resource Network, with its national public awareness and education campaign on ACEs (and NumberStory.org) will help promote Pathways to Resilience and will be developing customizable toolkits that states can use in their childhood adversity awareness efforts. Organizations like the National Governors Association’s Center for Best Practices, Social Contract, the Well Being Trust, the Campaign for Trauma-Informed Policy & Practice (CTIPP), the National Academy for State Health Policy (NASHP), and accomplished author and trainer, Becky Haas, have joined us in our planning and will continue to advise and promote the initiative. We will continue to leverage these partnerships by amplifying one another’s work to advance our shared goals.

Focus on the Silver Lining

One of the well-loved movies of the 2010s was Silver Linings Playbook, starring Jennifer Lawrence and Bradley Cooper. Although it is mostly a romantic comedy featuring a wacky ballroom dance number, the story is ultimately about how positive relationships and experiences can help us overcome adversity. We believe that Pathways to Resilience can become a “playbook” for states across the country that are committed to becoming trauma-responsive and preventing ACEs and toxic stress for future generations.We are excited to formally launch Pathways to Resilience in May 2022 – in honor of National Trauma Awareness month – and we hope you will join us!  In the meantime, please reach out to our co-leads, Tanya Schwartz (tanya@aurrerahealth.com) and Lauren Block (lauren@aurrerahealth.com), if you would like to learn more. if you would like to learn more. Stay tuned for updates and be sure to join our Pathwaysmailing list.

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Authors

Sarah Tocher [Policy Consultant]

Lauren Block [Vice President]