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Combatting Toxic Stress to Ensure Successful Youth

Social determinants of health (SDOH) refer to a broad range of social and environmental conditions that affect health and well-being, including access to safe housing, healthy foods, educational opportunities and healthcare services, among others. Growing up in poverty limits access to many of these fundamental needs and creates barriers to long-term health.

According to 2019 U.S. Census Bureau data, more than one in five, or roughly 500,000 children in North Carolina live in poverty. The state’s poverty rate for children under the age of five was even higher, at 22%. While the federal poverty guideline in 2019 was $25,750 for a family of four, research suggests that most families need an income of about twice the Federal Poverty Limit (FPL) to meet basic needs.

Many childhood health issues, including asthma, behavioral health concerns and malnutrition, are more common among children living in poverty. The impact of unhealthy living conditions can result in long-lasting negative effects on physical and emotional health. Children who experience these health challenges are more likely to experience a cascade of developmental and educational achievement issues. This toxic stress can lead to permanent changes in a child’s nervous system, with a direct link to adult chronic disease, including heart disease, cancer and substance use disorders.

Eliminating the barriers to childhood poverty remains one of the best solutions for success. Community action agencies have been working toward fulfilling this goal for nearly six decades. Research suggests that supportive, responsive relationships with caring adults as early in life as possible can prevent or reverse the damaging effects of toxic stress response. By teaching a child resilience coping strategies, it is more likely that the child can respond to negative situations in a healthy way, reducing or eliminating unfavorable outcomes.

The documentary Resilience: The Biology of Stress & The Science of Hope ex­plores the science of toxic stress, Adverse Childhood Experiences (ACEs), and the movement by pediatricians, social scientists, educators and communities who are using research to break cycles of violence, addiction and disease.

On April 29, the Partnership for Children of Wayne County and WAGES, the Wayne County Community Action agency, will host a free screening of Resilience. WAGES will host subsequent forums and trainings on mitigating toxic stress.


Elle Evans Peterson, MPH, CHES, is the Community Impact Manager – Social Determinants of Health at the North Carolina Community Action Association.

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