Surgeon General of California explained

Post:Surgeon General
Body:
the State of California
Insignia:Seal of California.svg
Insigniasize:120
Insigniacaption:Seal of the State of California
Incumbent:Diana Ramos
appointed August 25, 2022
Acting:no
Reports To:Governor of California
Appointer:The Governor
Formation:January 7, 2019
First:Dr. Nadine Burke Harris
Salary:$200,000

The Surgeon General of California is the leading spokesperson on matters of public health within the State of California. The Surgeon General is one of only five State Surgeons General in the United States. The office was created on January 7, 2019, by Governor Gavin Newsom[1] and requires confirmation from the California State Senate.[2]

The first Surgeon General was Dr. Nadine Burke Harris, who served from February 11, 2019, to February 11, 2022.[3] [4] [5] The Surgeon General is one key component of the Governor's "California for All" agenda which includes a proposed $1.7 billion in funding for expanded early childhood education and early interventions. Governor Newsom appointed two National Experts in Child Development to be Key Leaders in the effort to help the youngest Californians.[6]

On August 25, 2022, Governor Gavin Newsom appointed Dr. Diana Ramos as the California Surgeon General.[7]

Responsibilities

Top Priorities

History

The Surgeon General of California was created with the signing of Executive Order N-02-19[14] —one of the first acts taken by Governor Gavin Newsom on his first day in office—on January 7, 2019. At the time of the office's creation, the Office of the Surgeon General was the first of its kind in California and one of only four on a state level in the United States.

On January 21, 2019, Governor Newsom appointed Dr. Nadine Burke Harris to be California's first-ever surgeon general. She took office on February 11, 2019, and resigned her position on February 11, 2022. Shortly after the new Surgeon General was appointed, Dr. Nadine Burke Harris went on a Statewide Listening Tour.[15]

Increasing Awareness of Toxic Stress and ACES (Adverse Childhood Experiences Study[16])

Dr. Nadine Burke Harris has given many speeches and testimony to the impact of Toxic Stress on Children and how it impacts their future.

A PBS NewsHour opinion piece highlighted Nadine Burke Harris experience with Toxic Stress and how it is under-diagnosed in children.

A DISTURBING Washington Post video with Nadine Burke Harris explains Toxic Stress with powerful visuals and sound added to Dr. Burke Harris' explanation.

There are many websites and toolkits to better understand Toxic Stress and Adverse Childhood Experiences and their impact on health over a lifetime including ACES Too High, Harvard Center on the Developing Child,

Dr. Nadine Burke Harris has given multiple talks and had conversations that have been made public and available to the public on Toxic Stress including a famous Ted Talk that addresses Toxic Stress from a Public Health standpoint.

Trauma-informed care and Strengthening Resilience.

Necessary resources for medical, behavioral and educational professionals include resources to provide trauma-informed care.[17] Systems that work with children and their parents and extended families will need to create trauma-snformed systems where the children and their families are supported by staff who are also supported while caring for survivors of trauma.[18]

A service system with a trauma-informed perspective is one in which agencies, programs, and service providers:

  1. Routinely screen for trauma exposure and related symptoms.
  2. Use evidence-based, culturally responsive assessment and treatment for traumatic stress and associated mental health symptoms.
  3. Make resources available to children, families, and providers on trauma exposure, its impact, and treatment.
  4. Engage in efforts to strengthen the resilience and protective factors of children and families impacted by and vulnerable to trauma.
  5. Address parent and caregiver trauma and its impact on the family system.
  6. Emphasize continuity of care and collaboration across child-service systems.
  7. Maintain an environment of care for staff that addresses, minimizes, and treats secondary traumatic stress, and that increases staff wellness.

These activities are rooted in an understanding that trauma-informed agencies, programs, and service providers:

  1. Build meaningful partnerships that create mutuality among children, families, caregivers, and professionals at an individual and organizational level.
  2. Address the intersections of trauma with culture, history, race, gender, location, and language, acknowledge the compounding impact of structural inequity, and are responsive to the unique needs of diverse communities.

Challenges of Children Traumatized by Systems (i.e. Justice System, Border Patrol, Foster Care System, ICE, etc.)

Children who come to the attention of the juvenile justice system[19] are a challenging and under-served population, with high rates of exposure to trauma.

Unaccompanied Migrant Children who may have Complex trauma[20] prior to encounters with systems like Border Patrol or the Foster Care system.

Instituting Proper funding and care for Early Childhood Development and Intervention to address Social Determinants of Health will need to be a key part of building resilience into the systems that deal with children, especially in Early Childhood may become part of the overall plan for California and be supported by the Surgeon General.

In a Q&A Dr. Burke Harris was asked, "Gov. Newsom has made funding early education one of his highest priorities. How do you plan on incorporating trauma-informed teaching into the overall effort?"

In response she answered, "We’re understanding more than we ever had before the role of experience and environment in early childhood in shaping lifelong health outcomes. That is the data and research we are seeing across the board. So, when you look at something that is such a huge public health issue then we must recognize that to implement public health solutions we need to be engaging across sectors.

So, in our educational system, in our health system, in our justice system — across the board — we need to have broad-scale and coordinated efforts to address the impact of early adversity on health and development. Healthcare and early education go hand-in-hand."[21]

Trauma as a Toxin or Public Health Problem[22]

"Imagine identifying a toxin so potent it could rewire a child’s brain and erode his immune system. A substance that, in high doses, tripled the risk of heart disease and lung cancer and reduced life expectancy by 20 years.

And then realizing that tens of millions of American children had been exposed.

Nadine Burke Harris, is a leading voice in a movement trying to transform our understanding of how the traumatic experiences that affect children, can trigger serious physical and mental illness, and looking at it using epidemiology, like John Snow did in 1800s London.

Decades of research that has found that children who endure sustained stresses in their day-to-day lives undergo biochemical changes to their brains and bodies that can dramatically increase their risk of developing serious health problems, including heart disease, lung cancer, asthma, and depression."

List of surgeons general

NameServicePrior offices
1
February 11, 2019 – February 11, 2022none
2Diana RamosSeptember 1, 2022 – Present

References

  1. News: Gov. Newsom Appoints California's First-Ever Surgeon General . 31 January 2019 . NBC 4 Southern California . January 21, 2019.
  2. Web site: Codes Display Text . 2022-08-26 . leginfo.legislature.ca.gov.
  3. Web site: 2022-02-02 . California's first surgeon general, Dr. Nadine Burke Harris, resigns . 2022-08-26 . Los Angeles Times . en-US.
  4. News: Black Woman Appointed California's First-Ever Surgeon General. Leslie. January 30, 2019. 31 January 2019. The Chicago Crusader.
  5. Web site: Dr. Nadine Burke Harris Officially Sworn in as California's First Surgeon General. BOTWC. 2019-03-25.
  6. Web site: Governor Newsom Announces Two National Experts in Child Development will be Key Leaders in Administration's Efforts to Help the Youngest Californians. 2019-01-21. California Governor. en. 2019-08-21.
  7. Web site: 2022-08-25 . Governor Newsom Appoints Dr. Diana Ramos as California Surgeon General . 2022-08-26 . California Governor . en.
  8. Web site: EXECUTIVE DEPARTMENT STATE OF CALIFORNIA EXECUTIVE ORDER N-02-19. Newson. Gavin. 2019-01-07. Governor of California. 2019-08-20.
  9. News: This doctor pioneered a way to treat stress in children, a startling source of future disease. Chandler. Michael A.. October 6, 2016. The Washington Post.
  10. Adolescence. Committee On. Pediatrics. Council on Community. Health. Section on Adolescent. Dougé. Jacqueline. Dooley. Danielle G.. Trent. Maria. 2019-08-01. The Impact of Racism on Child and Adolescent Health. Pediatrics. en. 144. 2. e20191765. 10.1542/peds.2019-1765. 0031-4005. 31358665. free.
  11. 1159094600474038272 . DrBurkeHarris . “Health equity is unachievable unless racism is addressed through interdisciplinary partnerships with other organizations that have developed campaigns against racism.” @AmerAcadPeds issues 1st ever policy on impact of racism on child & adolescent health. https://pediatrics.aappublications.org/content/144/2/e20191765.
  12. Web site: ACEs Pioneer Nadine Burke Harris Named California's First-Ever Surgeon General. 2019-01-23. The Chronicle of Social Change. en-US. 2019-08-21.
  13. Web site: Bill Text - AB-340 Early and Periodic Screening, Diagnosis, and Treatment Program: trauma screening.. leginfo.legislature.ca.gov. 2019-08-21.
  14. https://www.gov.ca.gov/wp-content/uploads/2019/01/EO-N-02-19-Attested-01.07.19.pdf Order N-02-19
  15. Web site: California Surgeon General Dr. Nadine Burke Harris Launches Statewide Listening Tour. 2019-04-02. California Health and Human Services. en-US. 2019-08-21.
  16. Web site: Adverse Childhood Experiences (ACEs). 2019-04-23. www.cdc.gov. en-us. 2019-08-21.
  17. Web site: Trauma-Informed Care. Peterson. Sarah. 2018-02-28. The National Child Traumatic Stress Network. en. 2019-08-21.
  18. Web site: Creating Trauma-Informed Systems. Peterson. Sarah. 2018-01-30. The National Child Traumatic Stress Network. en. 2019-08-21.
  19. Web site: Justice. Peterson. Sarah. 2018-01-30. The National Child Traumatic Stress Network. en. 2019-08-21.
  20. Web site: Complex Trauma. Peterson. Sarah. 2018-01-25. The National Child Traumatic Stress Network. en. 2019-08-21.
  21. Web site: Q&A: California's first-ever surgeon general on her plans to tackle toxic stress in children. Washburn. David. EdSource. en. 2019-08-21.
  22. Web site: California Has an Innovative Plan to Deal With Childhood Trauma. Healthline. Anna Maria Barry-Jester, California. 2019-03-04. Vice. en. 2019-08-21.