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Amanda Merck

Merck completed her MPH with a concentration in Physical Activity and Health. She curates content for Salud America! (@SaludAmerica), a Latino childhood obesity prevention project based at the Institute for Health Promotion Research at UT Health San Antonio. She focuses on the latest research, resources, and stories related to policy, systems, and environmental changes to enhance equitable access to safe places for kids and families to walk, bike, and play.

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Articles by Amanda Merck

Healthy People 2030 Adds 4 Objectives on Childhood Trauma, Up From 0


Healthy People 2030

For the first time, the Healthy People 2030 guidelines have added four objectives on adverse childhood experiences (ACEs), a step to recognize the systemic impact of childhood trauma on health. ACEs, such as abuse and poverty, are a public health crisis. None of the past Healthy People editions ─ 1990, 2000, 2010, 2020 ─ had an objective to address ACEs as part of its national guidance to promote health and prevent disease. Now there are four objectives! This is a huge win for the 2,214 Salud America! network members who emailed public comments and other child development and public health professionals who submitted nearly 3,000 additional comments to add ACEs-related objectives. “I was surprised to learn ‘adverse childhood experiences (ACEs)’ and ‘childhood ...

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25,000 Comments Call for Safety Reforms in a Transportation Engineering ‘Bible’


Overhaul of the MUTCD

More than 25,000 public comments were submitted to the Federal Highway Administration (FHWA) on proposed changes to the Manual on Uniform Traffic Control Devices (MUTCD). Our team at Salud America! developed three model comments asking FHWA to adopt a public health and Safe System Approach to reframe and rewrite the 700-page MUTCD, one of transportation engineering’s “bibles” that guides road creation. More than 2,100 people visited our model comments over 30 days and nearly 450 people submitted our model comments. “This enormous volume of comments (a more than ten-fold increase over the last time the MUTCD was updated in 2009) demonstrates the degree to which Americans want change,” according to a post from the National Association of City Transportation Officials ...

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Tell Federal Highway Administration (FHWA): Overhaul Transportation Engineering Standards to Integrate Public Health



What we engineer and build impacts public health, safety, and welfare. However, transportation engineering prioritizes convenience for people driving over safety for people walking or biking. This makes streets more dangerous for everyone, including drivers. Now is our opportunity to change all that. Public comments are wanted on revisions to one of transportation engineering’s “bibles,” the 700-page Manual on Uniform Traffic Control Devices for Streets and Highways (MUTCD). The MUTCD, which was last rewritten 50 years ago from the point of view of expediting vehicle movement, is full of assumptions, restrictions, and contradictions that hinder efforts to improve safety and create vibrant, welcoming streets. Submit one of three Salud America! model comments to tell ...

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5 Upstream Ways You Can Take Action to Address Toxic Stress



Toxic stress is endangering the current and future health of our society. Amid the mental, physical, and economic toll of the COVID-19 pandemic, there is even greater need to prevent the risk factors for toxic stress, which are severe, intense, or prolonged stress, trauma, or adverse childhood experiences (ACEs) like physical, sexual, and emotional abuse. The new Roadmap for Resilience: The California Surgeon General’s Report on Adverse Childhood Experiences, Toxic Stress, and Health is the nation’s first guide to address toxic stress by cutting ACEs in half in a generation. We at Salud America! are exploring the roadmap in an 11-part series. This is the final post in the series, with five upstream ways you can take action to address toxic stress. “To enable ...

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California’s Epic Response to Toxic Stress and ACEs


California’s Epic Response to Toxic Stress and ACEs

California is leading the nation in addressing toxic stress and adverse childhood experiences (ACEs), such as neglect, divorce and exposure to violence, which can harm long-term health. Guided by evidence and a public health approach, California developed a series of legal and conceptual frameworks to support statewide screening for ACEs, coordinate within and outside state government, and assess best practices in trauma-informed care across the state. This progress ramped up when Gov. Gavin Newsom created the Office of the California Surgeon General  in 2019 and appointed Dr. Nadine Burke Harris to the position. In December 2020, Burke Harris released her Roadmap for Resilience: The California Surgeon General’s Report on Adverse Childhood Experiences, Toxic Stress, and ...

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45% Spike in People Walking Killed by People Driving, Says ‘Dangerous by Design’ Report


45% Spike in People Walking Killed by People Driving, Says 'Dangerous by Design' Report

America’s approach to road safety continues to fail, especially for pedestrians. The number of people walking who have been struck and killed by people driving grew 45% from 2010 and 2019, according to the new Dangerous by Design report from Smart Growth America and the National Complete Streets Coalition. Why? Policymakers in cities and states across the country continue to trust unsafe street design practices that prioritize speed for people driving, enable larger vehicles, and rely on police enforcement and ineffectual education campaigns to promote safety. Experts urge federal, state, and local leaders to adjust road design to prioritize pedestrians and other forms of active travel such as bicycling, as well as quit blaming individuals and relying on police. The Most ...

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Tell CDC: Add Social Risk Codes to Better Classify Disease Diagnoses, Symptoms (ICD-10-CM)


Tell CDC: Add Social Risk Codes to Better Classify Disease Diagnoses, Symptoms (ICD-10-CM)

Social risk contributes significantly to poor health. These social risks—also known as social determinants of health—include food insecurity, housing instability, transportation insecurity, financial strain, and more. But without the right terminology about social risk, doctors and other healthcare workers may struggle to identify, support, and report patient’s social needs, which can harm health and hinder research. This is particularly problematic for Latinos and others who are overburdened by social risks. This why the Gravity Project, a coalition of experts on social risk, is recommending code changes and updates to CDC National Center for Health Statistics’ International Classification of Diseases-Clinical Modification, Tenth Revision (ICD-10-CM), which provides a ...

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Toxic Stress in Education and How to Prevent it


Toxic Stress in Education and How to Prevent it

Trouble concentrating in class. Not completing homework. Behavioral difficulties. Absenteeism. These outcomes are linked to exposure to adverse childhood experiences (ACEs). ACEs, such as abuse or parental substance abuse, can trigger the biological toxic stress response and hinder school learning, behavior, attendance, and academics. That’s why, in December 2020, Dr. Nadine Burke Harris released her Roadmap for Resilience: The California Surgeon General’s Report on Adverse Childhood Experiences, Toxic Stress, and Health. Salud America! is exploring the report as part of its 11-part series on toxic stress. Below are primary prevention, early detection, and early intervention strategies for education personnel to address ACEs and toxic stress among Latino and ...

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Toxic Stress in the Justice System and How to Prevent It


Toxic Stress in the Justice System and How to Prevent It EJ USA

Exposure to adverse childhood experiences (ACEs), such as poverty or abuse, is a known risk factor involvement in the justice system. And, involvement in the justice system may be an indicator of toxic stress. Thus, the justice system plays an important role in preventing the effects of ACEs and toxic stress. That’s why, in December 2020, Dr. Nadine Burke Harris released her Roadmap for Resilience: The California Surgeon General’s Report on Adverse Childhood Experiences, Toxic Stress, and Health. Salud America! is exploring the report as part of its 11-part series on toxic stress. “Factors that underlie connections between victimization or trauma and later criminal justice involvement provide a window into areas for primary and secondary intervention ...

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