The “sure thing” in promoting public health is investing in reducing childhood adversity. This understanding led the U.S. Centers for Disease Control and Prevention to develop the framework called “Safe, Stable, Nurturing Relationships and Environments.”

The framework calls on communities “to promote the types of relationships and environments that help children grow up to be healthy and productive citizens so that they, in turn, can build stronger and safer families and communities for their children.” With trillions of dollars spent on health care-related costs, very limited investments are directed toward conditions that would improve health before chronic illness develops.

As highlighted in the documentary film "Resilience: The Biology of Stress & The Science of Hope," the impetus for this public health campaign came, in large part, from the findings of the landmark Adverse Childhood Experiences study conducted in Southern California in the mid-1990s.

Dr. Vincent Fellitti was treating patients in an obesity clinic in San Diego, and he noted that some patients had difficulty maintaining their weight loss. He began to ask detailed history questions and found that more than half of his patients had been sexually abused as children.

Across the country, Dr. Robert Anda, an epidemiologist at the U.S. Centers for Disease Control and Prevention, was conducting research on the apparent link between depression and the choice to use cigarettes, and the increased difficulty of quitting tobacco for those with chronic depression.

The two physicians joined forces in developing a detailed health survey for patients of the Kaiser Permanente HMO serving Southern California. They obtained personal information from more than 17,000 patients, which, when compared with their health records, demonstrated that an accumulation of adverse experiences in childhood significantly increased the risk for many health and mental health problems in adulthood.

That population of primarily Caucasian, middle class, college-educated people reported that 28 percent of them had been physically abused, 27 percent had lived with a substance-abusing parent, 20 percent had been sexually abused, and 13 percent witnessed their mother being abused, for example.

The researchers used a device of adding a score for each of 10 selected adverse experiences and found that, as the “score” increased, so, too, did the risk for heart disease, cancer, mental health problems like depression and anxiety, addiction, and many other conditions. They published a report of their findings in 1998.

With the help of the Maine Children’s Trust and the Maine Resilience Building Network, Broadreach Family & Community Services was able to purchase licenses to display the "Resilience" film and facilitate discussions in Knox and Waldo counties. It has been shared with audiences 28 times since August 2017 and more public viewings are being scheduled through the end of May.

The next scheduled viewings are at the Capt. Albert Stevens School in Belfast Thursday, March 22, and at Oceanside Middle School in Thomaston Wednesday, April 4. Events in Brooks, Cushing, Lincolnville and Winterport will be announced soon.

To become involved in viewing and discussion, and for more information, you can contact the Midcoast Resilience Project at or connect with the project on Facebook.

Patrick Walsh, retired director of prevention services for Broadreach Family & Community Services in Belfast, is now with Midcoast Resilience Project.