What is truth?
That famous question from Pontius Pilate to Jesus has been on my mind recently, and not only because we heard it during the reading of the Lord’s Passion on Good Friday. It probably is on many people’s minds, given the difficulty of figuring out what sources of information are valid today, and what are not. Of course, in science we are supposed to be getting at the truth, growing closer to the truth as our work progresses.
And yet…
In early February, I picked up a book off the “New Non-Fiction” shelf at my local public library. Its title caught my eye: The Painful Truth about Hunger in America. The author of this book (published in 2024 by MIT Press) is Mariana Chilton, Professor of Health Management and Policy in the School of Public Health at Drexel University in Philadelphia. She has testified before the US Congress, co-chaired the congressionally-created bi-partisan National Commission on Hunger, been an advisor for Sesame Street, is widely cited by media, etc. She has credentials.
Her argument in the book is that we must unlearn everything we think we know about hunger (that’s in her subtitle, actually), because hunger in America really doesn’t have to do with food; it has to do with our society and with people’s life experiences. Yet in making her case, The Painful Truth says some interesting things about truth and painfulness and science — unintentionally.
This happens following a section titled “How Trauma Changes Mind, Body, and Relationships”. Chilton writes (page 86):
In the world of public health, there is an array of recognized experiences during childhood that are referred to as adverse childhood experiences (ACEs). ACEs can include exposure to physical, emotional, and sexual abuse as well as household adversity, such as witnessing violence in the home, having someone in the family who attempted/completed suicide, or having a parent who was sent to prison. These experiences are associated with many major public health problems such as depression, anxiety, cardiovascular disease, diabetes, sexual risk-taking, and early death.
Nadine Burke Harris, the first surgeon general of California and a pediatrician in the San Francisco Bay Area, helped bring ACEs to greater awareness and understanding. Through her work as a pediatrician, she began to connect the dots of family trauma and societal trauma and how they affected children, their families and communities. She explains the science in straightforward terms for how childhood exposure to violence, neglect, abuse, and family strife have a deep and lasting impact on a child’s nervous system, organs, and immune function through the stress response.
These stresses, Chilton goes on to say, “wreak havoc in our bodies and in our society.” And she emphasizes how research shows a connection between hunger and adverse childhood experiences (p. 100). She includes the following graphic, noting, “It is common practice among scientists to dissociate, or bypass context, to make a scientific case. Sometimes we feel that if we can prove something by numbers, it will make more sense, be more accepted, and establish credibility.”
The graphic shows nine different ACEs: emotional abuse, physical abuse, sexual abuse, physical neglect, emotional neglect, substance abuse in household, mentally ill household member, witnessed domestic violence, household member in prison. And it shows, from a study of 1255 female caregivers of children aged 3 or younger, that those women with an adverse childhood experience were more likely to be food insecure. For example, only 4% among the 1020 women in the study who were food secure had experienced physical neglect as a child, whereas 16% of the 145 women who had low food security had that experience, and 18% of the 90 women who had very low food security had that experience. This ACEs effect endures despite government programs to provide food assistance: “We found that even when families participated in SNAP or WIC, the strong relationships between childhood adversity and food insecurity persisted.” In other words, Chilton is saying that what people experience as a child is not made up for by government food programs — thus the argument that hunger in America is not about food, and thus cannot be fixed by government or charities.
But then…
Appendix 2 in the back of the book shows “ACEs Questions and Scoring” used in the studies Chilton cites. And there are ten, not nine, different ACEs. One is left out from the graphic above. Which one? Number six: Were your parents ever separated or divorced?
Note that the graphic references a 2016 paper published in the American Journal of Preventive Medicine: “Childhood Adversity and Adult Reports of Food Insecurity Among Households With Children”, by Jin Sung et al. Chilton is one of the “et al.” authors of the paper. A research brief from Drexel’s Center for Hunger-free Communities includes a similar graphic to the one in the book — but with all ten ACEs.
And the “separated or divorced” ACE is the biggest of all. Whereas 97 of the women in the study reported the “physical neglect” ACE, 358 reported the “separated or divorced” ACE. The next largest group, reporting childhood emotional neglect, was 299 women.
And “separated or divorced” was third highest in terms of impact; the authors of the paper write, “Among participants reporting VLFS [Very Low Food Security], 55.6% reported emotional neglect, 44.4% reported exposure to household substance abuse, 43.3% reported loss of a parent through divorce or abandonment, and 41.1% lived with household members with a mental health condition.”
The “separated or divorced” ACE affected the most women, and showed a high impact on the women it affected. So why was it left out of The Painful Truth? Did the author of the book make the choice to leave it out? Was it perhaps the publisher’s idea? Who knows? But it appears that the “separated or divorced” science was too much, even for a book whose title is The Painful Truth.
Coincidentally, on February 7, shortly after I had picked up the book, the public radio show “This American Life” ran “stories from the heart of heartbreak” (this “for Valentine’s Day”). One of these was the story of eight-year-old Betsy Walter, who in the 1980s wrote to the mayor of New York City (then Ed Koch) because her parents were getting divorced. She ended up being interviewed by Noah Adams on NPR’s “All Things Considered”. She was deeply bothered by her parents’ divorce — “I really don’t know who to turn to,” she said. The mayor had told her to remember that she was loved, and that people cared about her. Adams assured her, “It’s kind of a sad thing, but most people get through it all right, too.”
But it seems that, according to people in the world of public health, lots of people don’t get through it all right, to the point that it makes them more likely to be food insecure as young parents. Public health researchers put the childhood experience of divorce as an ACE alongside physical abuse, sexual abuse, drug and alcohol abuse in the home, and other terrible things for which no one would offer platitudes to an eight-year-old who was experiencing them.
Of course, the people in the world of public health could be wrong here. Science is not always right, especially when the science studies people. Brother Guy and I wrote a book about that (click here for it).
But, we also wrote that nevertheless science is often the best we have; over the long term it has a good track record. We can’t just ignore it when it seems to be pointing to painful truths.
Obviously, this is touching on a different sort of “religion and science question” than those we usually think of, like evolution. The Catechism of the Catholic Church (2385) states that divorce “introduces disorder into the family and into society. This disorder brings grave harm … to children traumatized by the separation of their parents …. truly a plague on society.” Science here seems to agree with religion. But the truth that science seems to be revealing might be too painful even to make it into a book called The Painful Truth.
