Vincent J. Felitti

This article describes the origins of the Division of Health Appraisal in Southern California Permanente Medical Group's San Diego Department of Preventive Medicine, which provided a comprehensive and nontraditional array of preventive medicine services to more than 50,000 members a year. The fusion of Health Appraisal with the Positive Choice risk abatement services provided the origins of the now internationally recognized Adverse Childhood Experiences Study and its major implications for the outcomes and costs of medical care.The Health Appraisal system fulfilled the medical evaluation and preventive needs of most adult patients outside of the traditional and costly sickness-care system, provided rapid access to medical care, has been medically reliable and appreciated by patients, and demonstrably reduced the cost of medical care while providing each evaluated member with a comprehensive medical record in a specialized database. The unexpected resistance to this concept's further implementation deserves exploration and understanding given the current problems in medical care.This article will discuss: Health Appraisal development and function; the Health Appraisal process; perspectives on the Health Appraisal product, outcomes, and benefits; and the Positive Choice system that linked Health Appraisal to prevention activities. A proposal for program expansion and the major economic implications of certain Adverse Childhood Experiences Study findings also will be discussed.

Susan D Hillis, PhD, MS; Robert F Anda, MD, MS; Shanta R Dube, PhD, MPH; Vincent J Felitti, MD, FACP; Polly A Marchbanks, PhD; Maurizio Macaluso, MD, DrPH; James S Marks, MD, MPH Fall 2010 - Volume 14 Number 3 Abstract Background: Few reports ha

Vincent J Felitti, MD, FACP; Kathy Jakstis; Victoria Pepper, MS; Albert Ray, MD Spring 2010 - Volume 14 Number 1 Since 1982, the Southern California Permanente Medical Group’s Positive Choice Weight Loss Program in San Diego has treated mor

Strong relationships between exposure to childhood traumatic stressors and smoking behaviours inspire the question whether these adverse childhood experiences (ACEs) are associated with an increased risk of lung cancer during adulthood.

Prescription drugs account for approximately 11% of national health expenditures. Prior research on adverse childhood experiences (ACEs), which include common forms of child maltreatment and related traumatic stressors, has linked them to numerous health problems. However, data about the relationship of these experiences to prescription drug use are scarce.