Strengthen Fragile Families by reaching out to
those coping with homelessness, mental illness, substance abuse and domestic violence — some of the strongest risk factors for child abuse and neglect.
Earlier this week the Department for Work and Pensions select committee published evidence that the reduced cap was leading to sharp rises in the number of people affected outside London,
with increased workloads for Citizens Advice and
homelessness charities as people struggled to
cope with the sudden loss of income.
Briefly this fictionalized patient, who we will name Sam, is a 13y / o boy who was being treated for diabetes and has
coped with trauma and
homelessness, child protection involvement and family addiction.
Multiple life stressors, such as a family history of abuse or neglect, health problems, marital conflict, or domestic or community violence - and financial stressors such as unemployment, poverty, and
homelessness - may reduce a parent's capacity to
cope effectively
with the typical day - to - day stresses of raising children.
These toxic stress - induced changes in brain structure and function mediate, at least in part, the well - described relationship between adversity and altered life - course trajectories (see Fig 1).4, 6 A hyper - responsive or chronically activated stress response contributes to the inflammation and changes in immune function that are seen in those chronic, noncommunicable diseases often associated
with childhood adversity, like chronic obstructive pulmonary disease (COPD), cirrhosis, type II diabetes, depression, and cardiovascular disease.4, 6 Impairments in critical SE, language, and cognitive skills contribute to the fractured social networks often associated
with childhood adversity, like school failure, poverty, divorce,
homelessness, violence, and limited access to healthcare.4, 19,58 — 60 Finally, behavioral allostasis, or the adoption of potentially maladaptive behaviors to deal or
cope with chronic stress, begins to explain the association between childhood adversity and unhealthy lifestyles, like alcohol, tobacco, and substance abuse, promiscuity, gambling, and obesity.4, 6,61 Taken together, these 3 general classes of altered developmental outcomes (unhealthy lifestyles, fractured social networks, and changes in immune function) contribute to the development of noncommunicable diseases and encompass many of the morbidities associated epidemiologically
with childhood adversity.4, 6