by Guest Author Sharon Hirsch, President & CEO, Positive Childhood Alliance North Carolina

We’ve known for some time that adverse childhood experiences (ACEs) can impact health and well-being across the lifespan. However, emerging research suggests something just as powerful, if not more so: the absence of positive childhood experiences (PCEs) may be more damaging to long-term health outcomes than the presence of ACEs [1-4].

PCEs can build the foundation for someone’s ability to cope and thrive, buffering the impact of ACEs. And while preventing and treating the impacts of ACEs is essential, it is not enough. To build a healthier, more resilient, and hopeful future for North Carolina, we must shift our focus toward intentionally creating more positive experiences and environments where children and families can thrive.

What are Positive Childhood Experiences?

Research has identified 7 key PCEs that serve as protective factors for long-term well-being [5]:

1. The ability to talk with family about feelings.
2. The sense that family is supportive during difficult times.
3. The enjoyment of participation in community traditions.
4. Feeling a sense of belonging in high school.
5. Feeling supported by friends.
6. Having at least 2 non-parent adults who genuinely cared.
7. Feeling safe and protected by an adult in the home.

Just like ACEs, the benefits of PCEs are dose-responsive: the more positive experiences a child has, the more likely they are to have better mental health as adults.

At our recent Leadership and Learning Summit, Dr. Bob Sege, founder of the Healthy Outcomes from Positive Experiences (HOPE) Framework [6] put it simply:

“Positive experiences are the food, not the medicine.”

PCEs are not just an antidote to adversity; they are the foundation for healthy development. And they are vital for all of us.

The HOPE Framework lays out 4 building blocks that create the conditions for these experiences:

1. Relationships within the family and with other children and adults through interpersonal activities.
2. Safe, equitable, stable environments for living, playing, and learning at home and in school.
3. Social and civic engagement to develop a sense of belonging and connectedness.
4. Emotional growth through playing and interacting with peers for self-awareness and self-regulation.

As Christina Bethell, PhD, MBA, MPH, from Johns Hopkins reminded us at the Summit, “eliminating risk is not enough.” If we want our children to grow up safe, healthy, and resilient, that is what we must promote. She emphasized the importance of parent-child connection, both biologically and neurologically, when she said, “All that sparks hope are our relationships with one another.” And while Dr. Sege focused on PCEs as the food, not the medicine, Dr. Bethell explained that “We are the medicine. Your well-being influences their well-being.”

The Science of the Positive teaches us that if we want health, we must promote health [7]. Yet, parents and children are struggling today with post-pandemic effects—from the impact of social media on children’s development, from challenges accessing childcare, from balancing work and family, and so much more. When parents and caregivers are struggling, their children will struggle. Positive experiences for adults matter, too.

To help families thrive with hope for the future, we are changing the conversation about what families need through our policies, programs and practices. Together, we must build systems that create and multiply opportunities for positive experiences:

• Tax policies that reduce financial stress.
• Investments in parenting programs that build skills and confidence.
• Access to quality, affordable child care.
• Safe, connected neighborhoods that foster play and belonging.
• Traditions and community celebrations that offer joy and continuity.

When we intentionally prioritize PCEs, we aren’t just preventing harm—we’re building a hopeful future. A future where all children grow up with hope. A future where North Carolina leads as a place where families can live, work, play, and thrive.

If we want a healthier, more prosperous North Carolina, it starts with positive childhoods. Let’s make that our shared commitment.

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Guest posts represent the author's views and do not necessarily reflect those of the NCIOM.

References

1. Bellis MA, Hardcastle K, Ford K, Hughes K, Ashton K, Quigg Z, Butler N. Does continuous trusted adult support in childhood impart life-course resilience against adverse childhood experiences - a retrospective study on adult health-harming behaviours and mental well-being. BMC Psychiatry. 2017;17(110). https://doi.org/10.1186/s12888-017-1260-z

2. Carroll JE, Gruenewald TL, Taylor SE, Janicki-Deverts D, Matthews KA, & Seeman TE. Childhood abuse, parental warmth, and adult multisystem biological risk in the coronary artery risk development in young adults study. PNAS. 2013;110(42):17149–17153. https://doi.org/10.1073/pnas.1315458110

3. Crandall AA, Broadbent E, Stanfill M, et al. The influence of adverse and advantageous childhood experiences during adolescence on young adult health. Child Abuse & Neglect. 2020;108:104644. https://doi.org/10.1016/j.chiabu.2020.104644

4. Crandall A, Miller JR, Cheung A, et al. ACEs and counter-ACEs: How positive and negative childhood experiences influence adult health. Child Abuse & Neglect. 2019;96:104089. https://doi.org/10.1016/j.chiabu.2019.104089

5. Bethell C, Jones J, Gombojav N, Linkenbach J, Sege R. Positive childhood experiences and adult mental and relational health in a statewide sample: Associations across adverse childhood experiences levels. JAMA Pediatrics. 2019;173(11):e193007. doi:10.1001/jamapediatrics.2019.3007

6. Every child needs positive childhood experiences (PCEs). HOPE. Accessed April 16, 2025. https://positiveexperience.org/

7. Linkenbach J; The Science of the Positive: The Seven Core Principles Workbook. The Montana Institute, LLC; 2007; 2018.