It’s hard to concretely characterize the causes and effects of “trauma”, as it can take a variety of forms. Trauma can stem from adverse childhood experiences (ACEs), singular traumatic events, or historical and intergenerational consequences from deeply rooted societal structures. Generally, it is defined as a “response to a deeply distressing or disturbing event that overwhelms an individual’s ability to cope, causes feelings of helplessness, and diminishes their sense of self and their ability to feel a full range of emotions” (Routsis, 2022). Trauma has a large impact on health as it disturbs proper nervous system functioning—and for marginalized communities that often lack the support to heal, this can have severe downstream effects on other aspects of biological and social function. Because of a lack of trauma-informed healthcare systems, marginalized populations don’t receive adequate and equitable care, and are less likely to utilize healthcare overall. Righteously so, minorities also have mistrust in the western medical system because of the colonial, exploitative history of using people of color for the advancement of medicine. This sustains barriers to care that are exacerbated by the system’s oversight of trauma.
So, how can healthcare systems become more trauma-informed to support minority and marginalized groups? The change must occur on a system-wide and institutional level, but individual hospitals or healthcare providers can also implement trauma-informed care in their practice. One approach is to implement collaborative care models that screen for trauma and stress in patients, normalizing and encouraging the consideration of trauma in healthcare. Medical treatment and actual delivery of care should then be adjusted, and patients should be provided behavioral and social health referral options—which hopefully can improve overall patient prognosis. Some hospitals currently screen children for ACEs, but adults are not screened for chronic trauma and toxic stress. Of course, there are many ethical considerations associated with trauma screening that hospitals must navigate before implementing such procedures on a broader level. It’s important not to stigmatize, discriminate against, or ostracize groups through this process, and hospitals must be careful as to not retraumatize patients or create unnecessary discomfort for vulnerable patients. We must also question if trauma awareness and education should be incorporated in the same sphere as healing, as it is still unclear whether open conversation surrounding trauma generally helps or hinders the healing process. Exposure to the idea of trauma in an educational setting can help some people question what their feelings of loneliness and anxiety are attached to, yet for others, it may cause inadvertent harm.
Healthcare providers must also be aware of their own culture and perspectives, and how that affects how they serve patients from similar or different backgrounds. For some patients, healing from trauma comes from resilience and connecting with their culture. However, the western medical system has excluded many aspects of traditional and holistic health approaches that may be more suitable and effective for people of different cultures, and exposure to the western biomedical model could be traumatic. Thus, there must be more discourse surrounding trauma and culture in healthcare amongst a diverse workforce, so that a better system is created to improve quality of care for the marginalized.
Edited by: Kelly Ma
Graphic Designed by: Priya Meesa
References
Center for Violence Prevention and Recovery. (n.d.). Trauma-Informed Care Tips Sheet for Healthcare Providers. BIDMC of Boston. Retrieved October 2022, from https://www.bidmc.org/centers-and-departments/social-work/center-for-violence-prevention-and-recovery
Key ingredients for successful trauma-informed care implementation - samhsa. (n.d.). Retrieved October 2022, from https://www.samhsa.gov/sites/default/files/programs_campaigns/childrens_mental_health/atc-whitepaper-040616.pdf
Roberts, A. L., Gilman, S. E., Breslau, J., Breslau, N., & Koenen, K. C. (2011). Race/ethnic differences in exposure to traumatic events, development of post-traumatic stress disorder, and treatment-seeking for post-traumatic stress disorder in the United States. Psychological medicine, 41(1), 71–83. https://doi.org/10.1017/S0033291710000401
Routsis, F. (2022, June 2). What is trauma? - definition, symptoms, responses, types & therapy. Unyte Integrated Listening. Retrieved October 2022, from https://integratedlistening.com/what-is-trauma/
Trauma and Resilience. Wilder foundation. (n.d.). Retrieved October 2022, from https://www.wilder.org/sites/default/files/imports/AnokaCountyMWCtrauma%20Snapshot_10-14.pdf
What are aces? and how do they relate to toxic stress? Center on the Developing Child at Harvard University. (2020, October 30). Retrieved October 2022, from https://developingchild.harvard.edu/resources/aces-and-toxic-stress-frequently-asked-questions/