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By Andrea Blanch, Ph.D. and David Shern, Ph.D.

On many measures, our society is now considerably less safe, healthy, and economically productive than other comparable countries. Toxic stress and trauma, especially when coupled with genetic vulnerability, are seriously eroding our public health, social stability, and world leadership. 

In two recent papers, we argue that our well-being depends on the well-being of our neighbors as much as our health depends on their health.  Poor health and mental health, poverty, violence and failing schools are no more inevitable than cholera or yellow fever. Applying our knowledge about the root causes of these problems will lead to improvements in public health and well-being not seen in a century. 

The Ebola crisis was a stark reminder of our vulnerability to infectious diseases in this age of globalization. With Ebola, it is easy to understand that our health is connected to the health of others. We might debate the best intervention strategies, but it is obvious that we need to contain the disease, prevent others from contracting it, provide the best possible care for those who get sick, and find and make available effective treatments. And although the public is rightfully fearful about this epidemic, no one doubts that eventually it will be brought under control.

A hundred and fifty years ago, that wouldn’t have been the case. Infectious diseases like cholera and yellow fever, which regularly killed thousands, were considered a tragic but unavoidable fact of life.  But once we understood the root causes of infectious diseases, all sectors of society mobilized in response. As a result, during the twentieth century we witnessed the greatest improvement in the public’s health in history.

But there are factors today that are just as dangerous as infectious disease.

There is now compelling evidence that toxic stress and trauma, particularly in early childhood, affect the developing brain. This sets off a “cascade” of problems which, if unaddressed, lead to emotional, intellectual, behavioral and general health problems throughout life. Ultimately, these factors undermine our human and social capital and put us all at risk.

This does not have to be the case.  We understand enough about them to take action.

What we need now is a social movement demanding that we implement our knowledge and the political courage to tackle the issues. Our papers lay out our case – which we think is compelling – in  much greater detail. We would love to hear your thoughts and reactions or comments on this blog post. If you would like to comment, you can email us at We are looking forward to hearing from you. The time to act is now.

Andy Blanch, PhD, has been an advocate for the development of trauma-informed public policies and programs for the past 30 years. 
David Shern picture

Dr. David Shern is the Senior Science Advisor at Mental Health America having served as its President/CEO from 2006-2014. He is also has a faculty appointment in the Department of Mental Health at the Hopkins Bloomberg School of Public Health and previously was a Dean and Professor at the University of South Florida.


Ricky (not verified)

Thu, 01/29/2015 - 12:12

44% of all cigarettes are smoked by people who have a mental illness. Last year 480,000 people died of smoking related illnesses. We need a strong campaign to turn the 44% number around. With people who have a mental illness dying on average 20 years younger than the rest of the population, we need action on these statistics now.

Hafizullah (not verified)

Sun, 02/01/2015 - 02:25

Trauma is so pervasive in this society that we take the effects of it for granted as the "norm." ... and we traumatize children to make them "normal." THAT's what we're up against..

Randy (not verified)

Fri, 02/13/2015 - 20:26

While a good example of how our country is not all that prepared for an epidemic, the threat of ebola pails in comparison to the proliferation of mental health issues. Our country pays lip service to the need for mental health reform, but that's all it is. Luckily, free online mental health resources like, and have risen to meet what is clearly a need. We all need access to affordable mental health care. While the ACA was a step in the right direction, we still have a long ways to go. If we did not, these free counseling resources would probably not be so popular.

Navin (not verified)

Thu, 02/19/2015 - 20:13

Thanks for the great post and compelling paper. Why do you think toxic stress is more pervasive today than it would have been in the past? I would think that since the world was more violent and less stable people would have had higher levels of toxic stress.

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