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The Effects of Toxic Stress on Youth and the Economy


Recent research has found that what happens to people during childhood and adolescence can have surprisingly large effects on their adult experiences. The labor market is an important example. While people can obviously always learn new skills, the skills and knowledge acquired before they start working help to determine a great deal of their work history once they do start working. A major obstacle to acquiring skills and knowledge in childhood is toxic stress, which is the unmitigated biological response to threats that happen in the absence of social and emotional buffers. Relational health uses social and emotional supports for children to help them navigate and minimize the toxic stress responses to adverse childhood experiences such as abuse, neglect, exposure to violence, and poverty. What is known about how toxic stress affects youth development? And what can be done to mitigate its effects on people’s subsequent labor market success?



Charles Cox

Key takeaway: Charles Cox talks about his passion for supporting kids, describes the reality of toxic stress, and explains why patience and empathy are so important when dealing with toxic stress responses.

Andrew S. Garner

Key takeaway: Andrew S. Garner describes how childhood adversity can become biologically embedded through toxic stress to cause negative outcomes in adulthood. But he also describes emerging research on the ways that safe, stable, and nurturing relationships with adults can ameliorate toxic stress and lead to positive outcomes.

Faye Gary

Key takeaway: Faye Gary shares her remarkable life story and describes how her Provost Scholars mentoring program is creating advantages for children in East Cleveland.

Participant Bios

  • Charles Cox is a family support specialist at the Ginn Academy for Say Yes to Education Cleveland. Say Yes to Education is a nonprofit that galvanizes cities around the goals of every public-school student not only graduating high school but doing so with the support to attain, afford, and complete a postsecondary education. At the heart of Say Yes is a powerful incentive: the prospect of a college scholarship. The Ginn Academy is an all-boys high school in Cleveland, Ohio, founded by the legendary football coach Ted Ginn Sr. and where students are guided by scholarship, leadership, and service to all of humanity.

  • Andrew S. Garner is a Clinical Professor of Pediatrics at Case Western Reserve University School of Medicine. He earned a PhD in Neuroscience in 1996 followed by a Doctor of Medicine with distinction in neuroscience in 1997, both from Case Western Reserve University School of Medicine. Dr. Garner’s research and work have made him a leader on adverse childhood experiences (ACEs) and childhood toxic stress responses; he has served as the Chair of the Leadership Workgroup on Early Brain and Child Development for the American Academy of Pediatrics (AAP). Dr. Garner is a co-author of the influential report from the AAP, The Lifelong Effects of Early Childhood Adversity and Toxic Stress, as well as the book Thinking Developmentally: Nurturing Wellness in Childhood to Promote Lifelong Health.

  • Faye Gary is a Distinguished University Professor at Case Western Reserve University. She is a faculty member in the Bolton School of Nursing as well as a fellow of the American Academy of Nursing and a faculty associate at the Schubert Center for Child Studies. She holds a secondary appointment in the department of psychiatry in the School of Medicine at Case Western. She earned an MS in children’s psychiatric nursing and adolescent anthropology from Saint Xavier University and an EdD in special education and anthropology from the University of Florida. Dr. Gary is a founding director of the Provost Scholars Program, a partnership between Case Western and East Cleveland City Schools to improve the academic outcomes of middle and high school students through academic-related activities at Case Western and mentoring relationships with faculty and staff volunteers.

The views expressed in this Cleveland Fed Conversation on Economic Inclusion are those of the participants and are not necessarily those of the Federal Reserve Bank of Cleveland or the Board of Governors of the Federal Reserve System.

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