"It is easier to build strong children than to repair broken men." -Frederick Douglass (1817–1895)
What is stress? What constitutes stress in T&T? No feting for a ten days? Stopping at a red light? Listening to Parliament for two days in a row? Or watching TV ads for the internal elections of the UNC? Stress is the body's reaction to any stimuli that disturb its equilibrium. Everyone knows what it feels like to be stressed: your heart rate and blood pressure go up; your stress hormone levels are activated; your immune system is activated; your blood sugar rises. All this is good for you, because it helps you deal with an acute threat. Stress is a normal part of life. So we're not talking about eliminating stress in people's lives. And in children's lives, learning to deal with normal stress is part of healthy development. But there are some causes of stress that are much more severe than just the first day in day care, or getting a shot at the health centre. Toxic stress is when our stress response systems are activated and stay activated for prolonged periods of time. When stress is basically what life is usually like for you, this has a wear-and-tear effect on the body. In adults, it accelerates atherosclerosis and diabetes and increases the risk of heart attack and stroke. It increases vulnerability to anxiety and depression. Most importantly, in children, it disrupts brain circuits as they are developing. This kind of stress can begin in utero and, contrary to popular belief, affects foetuses and children.
The key issue, however, about toxic stress in children is not the cause of the stress, it's the fact that there aren't consistent, protective, reliable, supportive adult relationships to help children get through and learn to deal with adversity. This is the stress we see in cases of chronic neglect, recurrent abuse and the kind of unremitting stresses of deep poverty, where a family, from day to day, living a life immersed in violence, still cannot put food on the table. Recent figures say that 78 per cent of Trinis believe that poverty is a major problem in T&T and that at least 200,000 people are living below the poverty line. According to the American Academy of Pediatrics, "Childhood adversity research suggests that:
"(1) Early experiences with significant stress are critical, because they can undermine the development of those adaptive capacities and coping skills needed to deal with later challenges;
"(2) The roots of unhealthy lifestyles, maladaptive coping patterns, and fragmented social networks are often found in behavioural and physiologic responses to significant adversity that emerge in early childhood; and
"(3) The prevention of long-term, adverse consequences is best achieved by the buffering protection afforded by stable, responsive relationships that help children develop a sense of safety, thereby facilitating the restoration of their stress response systems to baseline."
The absence of stable, responsive caretakers, due to societal changes, ie, the increasing single-parent family, and families with two working parents or the loss of the "tantie" or "granny" figure-so beloved of local commentators and paediatricians-and the establishment of inadequate "day care" centres, where children are essentially left abandoned during the day, contributes to this toxic stress environment.Significant childhood adversity disrupts the architecture of the developing brain and influences behavioural, educational, economic, and health outcomes dec-ades and generations later. Gene- rations later! The King James version of the Bible, Exodus 34.7, says something similar: "visiting the iniquity of the fathers upon the children, and upon the children's children, unto the third and to the fourth generation." Interesting stuff, when ages-old beliefs are confirmed by science. Childhood toxic stress is linked to the development of unhealthy lifestyles like substance abuse, poor eating and exercise habits, persistent socioeconomic inequalities (school failure and financial hardship), and poor health such as diabetes and cardiovascular disease.
Toxic stress is defined as "the excessive or prolonged activation of the stress response systems in the absence of the buffering protection afforded by stable, responsive relationships." Where there is persistent interplay among positive (assets for health) and negative (risks for illness), toxic stress early in life plays a critical role by disrupting brain connections and setting us up for many adult diseases. It is precisely this interplay among our genetic predisposition, personal experiences (eg, family and social relationships) and environmental influences (eg, exposures to toxic chemicals and inappropriate electronic media) that affect learning, behaviour, and health through our lives. It is worth repeating that it is not adversity alone that predicts poor outcomes. It is the absence or insufficiency of protective relationships that reinforces healthy adaptations to stress, which, in the presence of significant adversity, leads to disruptive physiologic patterns that produce beha- viours that increase the risk of health-threatening activities and frank disease later in life. Given the extent to which costly health disparities in adults are rooted in these same unhealthy lifestyles, the reduction of toxic stress in young children ought to be a high priority for a government and health system that, in addition, repeatedly declares its concern and regard for children.
