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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

#SaludTues Tweetchat 2/9: Understanding ACEs and Toxic Stress


Understanding ACEs and toxic stress

Our bodies are wired for survival, thanks to our biological stress response system. However, without buffering protections, Adverse Childhood Experiences (ACEs), like neglect and abuse, can lead to a toxic stress response. The toxic stress response is a dysregulated biological stress response and subsequent changes to other physiological functions like the brain, hormonal systems, metabolism, immune response, and gene regulation. ACEs and the toxic stress response are associated with some of the most common, costly, and serious health conditions, including heart disease, cancer, dementia, and suicide. Fortunately, we can prevent and even mitigate toxic stress. Let’s use #SaludTues on Feb. 9, 2021, to Tweet about the lifelong consequences of ACES and toxic stress and ...

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Cut Toxic Stress with 3 Types of Public Health Prevention Interventions


Cut Toxic Stress with 3 Types of Public Health Prevention Interventions

To reduce the impact of a disease like diabetes, public health leaders usually apply a three-part preventive approach of prevention, early detection, and early intervention. But this preventive approach hasn’t been applied to toxic stress. Toxic stress is the body’s response to prolonged trauma─like abuse or discrimination─with no support. It can harm lifelong mental, physical, and behavioral health, especially for Latinos and others of color. Amid COVID-19, civil unrest, and an economic crisis, we need a public health prevention approach to address toxic stress now more than ever. A new roadmap can help. Dr. Nadine Burke Harris’ Roadmap for Resilience: The California Surgeon General’s Report on Adverse Childhood Experiences, Toxic Stress, and Health proposes a ...

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We Need to Recognize Toxic Stress as a Health Condition with Clinical Implications


Toxic stress is a health condition with clinical implications

There is a common health condition with serious medical consequences that has not been nationally recognized by the medical or public health community—toxic stress response. Toxic stress is the body’s response to prolonged trauma─like abuse or discrimination─with no support. It can harm lifelong mental, physical, and behavioral health, especially for Latinos and others of color. But few, if any, clinical treatment guidelines have strategies for mitigating the toxic stress response. That’s why Dr. Nadine Burke Harris’ Roadmap for Resilience: The California Surgeon General’s Report on Adverse Childhood Experiences, Toxic Stress, and Health wants California and others to recognize and respond to toxic stress as a health condition with clinical implications. “We ...

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Toxic Stress and its Lifelong Health Consequences


Toxic stress is a health crisis

Toxic stress is brought about by repeated stressful and traumatic experiences with no supportive relationships. This is causing huge mental and physical health problems for people across the nation, including Latinos and other people of color. Dr. Nadine Burke Harris even calls toxic stress a public health crisis. This is why she authored the Roadmap for Resilience: The California Surgeon General’s Report on Adverse Childhood Experiences, Toxic Stress, and Health. “We now understand that a key mechanism by which ACEs [adverse childhood experiences, such as divorce, abuse, poverty, etc.] lead to increased health risks is through a health condition called the toxic stress response,” Burke Harris’ roadmap states. Salud America! is exploring this issue as part of its ...

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11 Crucial Insights from the First Roadmap to Address Toxic Stress


Crucial Insights from the First Roadmap to Address Toxic Stress

Stress can happen for many reasons. Abuse. Discrimination. Poverty. But when the human body’s response to stressful situations is activated too frequently or intensely without supportive relationships, stress becomes more than “just stress.” It becomes “toxic stress.” And toxic stress can harm your brain, body, and behavior, and increase lifelong risk for disease, especially for Latinos and other people of color. Fortunately, we can address and even prevent toxic stress. 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 a main cause─adverse childhood experiences (ACEs)─in half in a generation. We at Salud ...

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In New Class Oaths, Medical Students Commit to Fight Racial Injustices


University of Houston College of Medicine Class of 2024 student reciting their oath. Source: University of Houston

In medical schools across the country, students in medical, nursing, and physician assistant programs participate in a ritual known as the white coat ceremony. This signifies the beginning of their journeys to achieve the long white lab coat, a well-recognized symbol of respect and professionalism. During the ceremony, students receive a short white lab coat and recite a class oath or pledge, acknowledging their obligation to compassion and scientific excellence as health care providers. Incoming students often write their own class oaths. This year, amid a civil rights movement protesting police brutality and global health pandemic, students at two medical schools stand out for writing class oaths that acknowledge racism’s impact on public health. These new oaths call for ...

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4 Reasons to Think Structuralist, Instead of Individualist, to Improve Health Equity



Every person is a unique individual. But if you look closely, you’ll see each person lives, learns, works, and plays within social and environmental conditions that influence their individual health and wealth. Some people face health barriers because of structural and systemic policies that curb their access to quality housing, transportation, medical care, food, jobs, schools, parks and other social determinants. Individuals have no choice when it comes to these structural health barriers. “Despite the tremendous, lifelong impact of our community conditions on our health, we focus most of our energy and resources on treating the outcomes of these problems but lack the essential urgency for attacking the root causes of poor health,” according to Brian C. Castrucci, Dr. ...

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Jennifer Rangel: Creating Bilingual Cartoons to Teach Zoning 101


Jennifer Rangel creates animated videos to teach residents about zoning

“Ever wondered why your neighborhood looks how it does?” Jennifer Rangel once asked herself this question. To find an answer, Rangel got a master’s degree in urban planning. Along the way, this Latina planner learned that discriminatory urban planning practices, like the zoning of land, had been used for white advantage for over a century, segregating communities and forging inequities in health and wealth among Latinos and other people of color. Rangel wanted to share what she learned. So she helped create workshops─then bilingual animated videos─to train neighborhood leaders, social workers, and others about zoning and how to get involved in zoning changes. “Understanding zoning is a critical step for residents as they try to undo previous harms and to ...

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Through Shared Ownership, Community Land Trusts Can Help Retain Housing Affordability


Community land trust

The prospect of homeownership remains out of reach for many Latinos as incomes fail to keep up with rising property values. The community land trust model is a shared ownership model designed to protect people, neighborhoods, and businesses at risk of gentrification and displacement due to development and the upward pressure of urban land markets. This model can be used for housing, small businesses, agriculture, and community resources. There are roughly 277 community land trusts across the US, many addressing housing instability. Community land trusts could play an important role in supporting economic recovery during and after COVID-19. Unfair Urban Land Markets Leave Many Families Behind Property rights in America were not created equal. They have excluded Latinos, ...

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