How Childhood StressMakes You Sick

In the mid-2000s, Dr. Nadine Burke Harris opened a children’s medical clinic in the Bayview section of San Francisco, one of the city’s poorest neighborhoods. She quickly began to suspect something was making many of her young patients sick.

She noticed the first clues in the unusually large population of kids referred to her clinic for symptoms associated with attention deficit hyperactivity disorder—an inability to focus, impulsivity, extreme restlessness. Burke Harris was struck not just by the sheer number of ADHD referrals, but also by how many of the patients had additional health problems. One child arrived in her clinic with eczema and asthma and was in the 50th percentile of height for a 4-year-old. He was 7. There were kindergarteners with hair falling out, two children with extremely rare cases of autoimmune hepatitis, middle-school kids stricken with depression and an epidemic number of kids with behavioral problems and asthma.

Burke Harris noticed something else unusual about these children. Whenever she asked their parents or caregivers to tell her about conditions at home, she almost invariably uncovered a major life disruption or trauma. One child had been sexually abused by a tenant, she recalls. Another had witnessed an attempted murder. Many children came from homes struggling with the incarceration or death of a parent, or reported acrimonious divorces. Some caregivers denied there were any problems at all, but had arrived at the appointment high on drugs.

Although none of her mentors at medical school back in the early 2000s had suggested that stress could cause seemingly unrelated physical illnesses, what she was seeing in the clinic was so consistent—and would eventually so alarm her—it sent her scrambling for answers.

“If I were a doctor, and I was seeing incredibly high rates of autism, I’d be doing research on autism,” she says. “Or if I saw incredibly high rates of certain types of cancer, I’d be doing that research. What I was seeing was incredibly, incredibly high rates of kids who were experiencing adversity and then having really significant health outcomes, whether it was difficulty learning, or asthma, or weird autoimmune diseases. I was seeing that the rates were highest in my kids who were experiencing adversity. And that drove me to the latest scientific literature.”

What Burke Harris found there would eventually thrust her to the forefront of a growing movement that aims to transform the way the medical profession handles childhood adversity. Childhood stress can be as toxic and detrimental to the development of the brain and body as eating lead paint chips off the wall or drinking it in the water—and should be screened for and dealt with in similar ways, in Burke Harris’ view. As California’s first Surgeon General, a newly created position, she is focusing on getting lawmakers and the public to act.

“What I was seeing was incredibly, of kids who were experiencing adversity and then having health outcomes.”