When Adversity Is the Norm, Not the Exception

We do not need statistics to tell us that childhood adversity shapes outcomes in adulthood – I have seen it up close. Growing up, I did not have the language for what I was witnessing; I just knew that stress, struggle, and survival were normal parts of my life. I watched how adversity moved through generations, how it lingered in silence, and how it showed up like a thief in the night. It wasn’t until I was sitting in a child and adolescent development lecture that I realized those experiences had a name: adverse childhood experiences, or ACEs. I realized that what felt personal was part of a larger, deeply rooted public health crisis disproportionately affecting the Black community.

The ACEs literature confirms what so many of us already know to be true–adverse childhood experiences are not rare. Nearly two thirds of adults in the U.S. report at least one ACE¹. ACEs include but are not limited to household dysfunction, exposure to violence, food insecurity, poverty, and parental involvement with the criminal justice system. ACEs are linked to depression, anxiety, substance use, and even early mortality ² ³ ⁷ ⁸. However, the literature does not reflect the full story. It does not capture experiences that are compounded and exacerbated by systematic inequalities within minority communities–under-resourced schools, limited access to healthcare, and the stress of discrimination⁴–that make it harder to escape their impact.

This is not just about “tough childhoods.” It is about what happens when the stress of that childhood becomes toxic. Over time, the accumulation of stress becomes what researchers call toxic stress⁵ ⁶.

Living In Survival Mode

Toxic stress occurs when a child is exposed to prolonged activation of the body’s stress response system, often leading to disruption in brain development, a weakened immune system, increased risk of chronic illness, mental health disorders, and unhealthy coping mechanisms⁵ ⁶. I have seen toxic stress not only as a theory or in my position working in an inpatient psychiatric facility, but also as a way of being. It looks like the child who is withdrawn and cannot focus in school, not because they do not care, but because their mind is in survival mode. It looks like a child who cannot sit still, because their body has learned to stay alert at home. It looks like the teenager with disruptive behavior, not because they are unruly, but because they are overwhelmed. It looks like an adult who turns to substances, not for pleasure, but for relief. It looks like the adult struggling with hypertension, not because they do not take care of themselves, but because their body has always been under stress.

When trauma and stress become ordinary, coping mechanisms often become pathologized and criminalized, but the root causes are never named and never treated.

What We Choose to See: Shifting the Question From “What’s Wrong?” to “What Happened?”

Too often, we talk about treating outcomes without acknowledging their origins. We often react, rather than prevent. We talk about substance abuse without talking about trauma. We talk about incarceration without talking about the household and environment. We talk about mental illness without examining how the very systems meant to treat it have made healing inaccessible.This fragmented approach keeps communities, such as the Black community already dealing with historical mistrust with the healthcare system, stuck in a perpetual cycle.

In order to break this cycle, we must shift the way in which we think about trauma and care. Trauma-informed care is a promising approach that asks a simple yet powerful question: “What happened to you?” rather than “What is wrong with you?” This shift matters. It recognizes the impact of past experiences and invisible histories on one’s behavior and health outcomes. Imagine if primary care providers or schools routinely screened for ACEs and connected families with resources before crises escalated⁵ ⁹. Implementing trauma-informed approaches and practices in schools, healthcare settings, and community organizations can create environments where people who are often at a disadvantage feel seen, understood, and supported.

The Power of Social Support

Equally important is the role of community and social support. Care cannot stop at institutions—it has to extend into communities. One of the most protective factors against the impact of ACEs is social support ¹⁰ ¹¹. Building a community that shows up and offers consistency can reduce health risks including depression and suicidal ideation in ways that policies alone cannot¹⁰. I have experienced the power of that support firsthand. Whether it was a teacher, mentor, or peers, leaning on those connections made a difference. They did not erase the challenges, but they made them more manageable. That is why community-based solutions matter. Investments in local programs, mentorship initiatives, and grassroots organizations that understand the lived experiences of the communities they serve matter. There is a strong need for partnerships between schools, healthcare providers, and community leaders to create systems of care that are accessible, trustworthy, and culturally competent.

Breaking the Pattern

Addressing childhood adversity in the Black community requires more than just awareness. It requires sustained investment. Investment in accessible and culturally responsive mental health services. Investment in schools that are equipped to serve and support, rather than punish students affected by adversity. Investments in historically under-resourced communities. And most importantly, investment in prevention–because by the time we are intervening and treating outcomes in adulthood, the impact is often already deeply rooted.

While this issue is personal to me, it is also urgent. It is about recognizing historical patterns, giving them a name, and refusing to accept them as the ordinary or inevitable. We have the research. We have the frameworks. What we need now is the collective will to act. Because Black childhood should not be defined by survival. And healing should never be a privilege.