Adverse Childhood Experiences (ACE), including childhood abuse/neglect, household dysfunction, and exposure to other traumatic stressors, have a large impact on health costs as well as social services, education, juvenile justice. Impact of ACE crosses socioeconomic boundaries. In 2011, the Vermont Department of Health reported that 58% of VT adults had experienced at least 1 ACE, and 17% of VT women had four or more ACEs.
Primary care physicians and emergency physicians have reported a surge in opiate abuse within the state of Vermont. It is being labeled as a public health epidemic and crisis, with a 2013 mortality rate of almost double what it was in 2012. There are several factors that play a role in why Vermont has seen such a growth in opiate abuse, from easy access to opiate dealers in major urban cities such as New York, Boston, and Philadelphia to a decrease in law enforcement coverage in rural areas of the state. One major element, and the focus of this project, is the lack of communication and awareness of resources for family members of abuse victims. Opiate abuse does not only affect the victim, it also affects their relationships, families, and friends. The major barrier to family members and friends seeking emotional, physical, spiritual, and mental support is the stigma that surrounds opiate abuse. If people don’t talk about the issue, this barrier cannot be overcome. There needs to be more information available to families, so they may seek out the appropriate resources and support needed to make strides towards helping their loved ones through their addiction’ This lack of communication among families in the community also contributes to the public health problem and the stigma of substance abuse; it results in a vicious cycle.
Fruits and vegetables are great, but they are not all created equally. In 2014, the Centers for Disease Control and Prevention published a study on which fruits and vegetables contain the most nutrients for preventing cancer, diabetes, and heart disease.
The top 41 have been named "Powerhouse Fruits and Vegetables."
Although obesity rates across all demographics continue to climb annually, when separated into income levels, the prevalence of obesity in poor adults and children are rising at a greater rate than middle class individuals. A recent publication by the Food Research and Action Center (FRAC) compiled a list of data points that indicated that, while the trend is gradually slowing, rates of severe obesity are about 1.7 times greater in children coming from families whose incomes fell below the poverty line than equal counterparts in the middle class income bracket. High fat, high carb foods are often the staple of a lower income family based on the assumption that they are more affordable, easier to prepare, and more time effective to gather, prepare, and consume. Because the cycle of poverty can be hard to escape, the cycle of high fat, high carb consumption is also passed on to subsequent generations. Unfortunately low income residential areas have a record of being "food deserts" where nutritious and fresh food is hard to find or overly expensive.
In the clinic we frequently see patients with self-admitted heavy drinking who are often in various stages of denial about their problems with alcohol. All the pamphlets and handouts available to patients at Thomas Chittenden Health Center and at Fletcher Allen Health Care are for patients who have admitted they have a problem with alcohol. These patients with admitted problems are the minority of patients with admitted heavy drinking. The patients who have not admitted their problem with drinking need a way to reflect on how their drinking is affecting their lives.
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