The Cleveland Clinic Foundation

Building Resiliency through Trauma-Informed Healthcare and Communities

Public health

We will create a dedicated center to advance trauma-informed clinical education and community-based interventions for children that improve lifelong health and minimize racial health disparities.

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Lead Organization

The Cleveland Clinic Foundation

Cleveland, Ohio, United States

http://www.my.clevelandclinic.org

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To learn more about – or provide significant funding to – this project, please contact Lever for Change.

Project Summary

Toxic stress and adverse childhood experiences severely impact infants, children, and adolescents. They harm developing brains and bodies in ways that manifest in poor health both immediately and in adulthood. 80% of a person’s overall health is a result of social determinants. In Northeast Ohio, toxic stress and trauma borne from structural racism and micro-aggressions are killing African Americans, from shockingly high infant mortality and youth suicide rates, to lifelong racial health disparities. To address these issues in Northeast Ohio and create models that are applicable nationwide, we will:•Form a Center for Trauma-Informed Care.•Educate pediatricians, OB/GYNs, and residents in trauma-informed care, unconscious bias, transgenerational trauma, and more. •Build a consortium of community-based organizations, schools, and other stakeholders to advance collaborative interventions addressing toxic stress and trauma in pregnant women, infants, children, and adolescents. •Evaluate the effectiveness of the above interventions to establish best practices

Problem Statement

Toxic stress and adverse childhood experiences (ACEs) severely impact the lives of infants, children, and adolescents. They harm developing brains and bodies in ways that manifest in poor health both immediately and into adolescence and adulthood. In Northeast Ohio—home of Cleveland Clinic—toxic stress and trauma borne from structural racism and micro-aggressions are killing African Americans, beginning in the womb. Infant mortality rates in our community are higher than in some developing nations: in Cleveland, black babies are five times more likely to die before their first birthday than white babies. Children living in poverty have fewer educational opportunities, leading to lifelong disadvantages. We also are experiencing a mental health crisis, with adolescent suicide attempts higher than the national average, and in some areas, the highest in the nation. These profound health inequities devastate individuals, families, and communities in Northeast Ohio—and beyond. It doesn’t have to be this way. We can teach clinicians to identify and respond to the effects of stress, trauma, and racism in children. We can create a model for trauma-informed healthcare that builds resiliency, fosters lifelong health, and minimizes racial health disparities. We can build the capacity of grassroots organizations and providers that serve families of color. We can form a model of a trauma-informed community that minimizes racial health disparities through cultural humility and evidence-based, collaborative interventions. We can prove the efficacy of our interventions and share best practices with communities across the nation.

Solution Overview

As an anchor-institution, Cleveland Clinic has the infrastructure, broad reach, and resources to build and convene a coalition of stakeholders. Working with community partners, we will implement best practices for trauma-informed care in treating pregnant, pediatric, and adolescent patients within our own institution; invest in grassroots and community organizations and enable them to build upon successful programs for families; and perform outcomes research to determine the effectiveness of these combined efforts. Dedicated staff within Cleveland Clinic will establish a Center for Trauma-Informed Care to oversee the three pillars of this coordinated effort. The aim of the center will be to promote health and healing for children and adolescents dealing with the repercussions of childhood trauma, and to serve as a model of care and research. At the center, we will: •Provide trauma-informed care to patients after a broad training program, including a train-the-trainer component, and focus on secondary trauma experienced by providers. •Partner with local organizations for bidirectional technical assistance that addresses prevention, screening, treatment, and recovery from childhood trauma.•Oversee qualitative and quantitative research for assessing programs, both within Cleveland Clinic and with our partners, with the understanding that such data is critical to developing effective strategies. Overall, these efforts will lay the foundation for a long-term, community-wide commitment to build resiliency by mitigating the effects of trauma and toxic stress in children.

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Project Funders

  • Health Resources and Services Administration 2019
  • The Hearst Foundations 2016 - 2017
  • The Char and Chuck Fowler Family Foundation 2015 - 2017

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