events. And, since January 2020,
California’s ACES Aware initiative
has been educating clinicians about
nonmedical interventions available to
patients facing adverse events, and
the state’s Medicaid program has
paid eligible providers $29 per
screening. Such regular screenings—
which involve asking intimate ques
tions in a nonthreatening and
supportive manner—are linked to
a variety of positive health outcomes.
A recent literature review found
patients associate these screenings
with greater trust in their doctors.
And clinicians say the screenings
help them identify social factors that
influence health, which allows them
to offer more effective care.
Lisa Gantz, a pediatrician at the
Los Angeles County Department of
Health Services, is one of more than
20,000 health providers in California
who have received free twohour
online training offered in the state.
By teaching her how to screen for
and respond to adverse events,
Gantz says the training has changed
the way she approaches clinical care.
She remembers one recent appoint
ment with an underweight four
monthold and his mother. “We had
gone through all of the feeding
[methods], and I really wasn’t able to
come up with a reason why this child
wasn’t growing,” Gantz says. But
when she talked to the mother gently
about possible changes at home,
Gantz learned the child’s parents had
recently separated. And the family
faced newfound financial hard
ship—a circumstance true of nearly
half of U.S. households by August
2020, according to a national survey.
“As soon as the mom felt safe, welearned that the husband was
deported, finances were tighter, and
the mom needed to water down her
son’s formula to make ends meet,”
Gantz says. “She was too embar
rassed to tell me that before, plus
a mom’s not going to walk in for
a checkup and say, ‘By the way,
dad’s not here anymore.’ But the
screenings create a space to have
these larger conversations aboutwhat’s going on at home.” With that
information, Gantz was able to
connect the mother and her baby
with a social worker and to public
services that could help them pay for
more formula.
Gantz describes the work of
treating adverse experiences as
creating a “medical neighborhood”—
a cohesive unit that responds to the
multifaceted nature of children’s MoMo Productions/Getty ImagesNEWS