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Rhonda Spencer-Hwang has learned some surprising things from 100-year-olds about resilience factors that have helped them live longer and fuller lives, despite difficult childhoods.
Question: Famously, Loma Linda is home to a relatively high number of people aged 100 and more. You have been interviewing these centenarians for your research. Can you tell us a little bit about why?
At the time I decided to do the research, I had a $2 million dollar grant from the First 5 Riverside organization and was going out providing educational services for 10,000 children and their families every year. I knew we had this designation as a Blue Zone and I thought there must be more I could do to help the families I was meeting in the community.
I am also a mom, and at the time I started this research, I was pregnant with my third child. I really wanted to know what I could learn from our Blue Zone centenarians (individuals over 100 years in age) and seniors (80+), and hear what advice they might have for parents to promote health and resilience in children.
We know that childhood is an important time in setting a foundation for a lifetime of health and wellness. I wanted to get advice from those who have lived the healthiest and the longest.
At the time, I knew not much research had been done looking into the childhood experiences of centenarians in general, and really no research assessing childhood experiences of those living in a Blue Zone.
My husband’s great aunt was the first centenarian I interviewed — this past March she turned 105!
You have studied how Adverse Childhood Experiences can decrease life expectancy, becoming factors in the development of many chronic diseases. Did you find that the Loma Linda centenarians had had relatively trouble-free childhoods?
No, it was actually quite the opposite. I wasn’t expecting to find what I did. I thought that since they lived to 100, their lives — especially their childhoods — must have been pretty stress-free. But what I found from interviewing centenarians and a number of seniors in our Loma Linda Blue Zone region is that their early lives were tremendously difficult. Each centenarian interviewed had a minimum ACE score of four. One centenarian had a score of six. And scientific studies have shown us that an ACE score of six or more should reduce one’s lifespan by 20 years. But even a score of four will most likely have some impact on health and longevity, and I could not imagine individuals living to 100 and in good health with that kind of ACE score. And everyone interviewed was in pretty good health, either living independently, with family or in an assisted living center. One centenarian interviewed was still driving her own car at 100. Clearly, these centenarians were able to overcome their ACEs.
So how have they been able to get past these difficult backgrounds and go on to live very long lives?
A total of eight positive themes emerged from my interviews with the centenarians and I identified them as resiliency factors. Every centenarian practiced these eight resiliency factors and each factor in independent studies has been identified as having anti-inflammatory properties, which is critical. There is a strong theory that individuals who live extraordinarily long lives are able to reduce chronic inflammation, also known as “inflammaging,” which is associated with the normal aging process.
A growing body of scientific evidence has linked environmental exposures and stressors in early life with the development of adult chronic diseases, ultimately decreasing lifespan. Researchers postulate that the embedding of adverse biological changes associated with toxic chronic stress, such as those associated with ACEs, may be through inflammatory mechanisms. Furthermore, the inflammatory processes may commence in early life, as studies have revealed the ACE associated increase in systemic inflammatory markers (CRP, fibrinogen and pro-inflammatory cytokines) and biological changes already evident in childhood. Alterations in inflammatory markers are now identified as candidate biomarkers for mediating the health consequences associated with childhood adversities and subsequently improving healthy longevity.
From my research, I observed that — starting early and throughout their entire lives — the centenarians practiced these eight resiliency factors, each with its anti-inflammatory properties.
What lessons are there for the average person in the findings you have gathered? What can we do to extend our lives as long as possible?
One of the lessons learned from the centenarians is to live a more simplified lifestyle. Across each of the eight resiliency factors is a common theme of simplicity.
The centenarians in early childhood came from farming families with limited financial means. So you can imagine what that meant for the children growing up. As the pace of society and the demands modern parents face intensify, we need to remember the wisdom and experiences of our centenarians and identify ways we can slow things down a bit for our own families.
One of the eight themes that emerged was spending time each and every day outdoors engaged with nature. For overscheduled parents, this may require us to schedule time for our children (and ourselves too!) to get outdoors and experience unstructured play. The great bonus for parents is that by getting outdoors, we are in essence experiencing the fountain of youth! Scientific studies have shown us that time outdoors can help reduce stress, improve mood and boost immune system.
Putting into practice the wisdom of the centenarians doesn’t guarantee that our children will live to 100, but we can certainly increase the odds for achieving a resiliently healthy long life.
What lessons are there for doctors and healthcare professionals?
Health professionals, a critical key stakeholder, can bring awareness for these resiliency factors and work to promote practicing of factors through conversation. They can start the conversation on resiliency factors with children and their families, even if it’s only one or two sentences during a clinic visit.
Another key stakeholder critical in supporting a shift towards a culture of health is medical facilities, hospitals, and administrators, as they could promote resiliency factors within their facility, encouraging wide exposure to them. Additionally, this stakeholder group could develop innovative collaborations with community organizations (i.e. museums, libraries, faith-based agencies, health departments) to promote community awareness and recognition of the resiliency factors.
There is a critical need for delivering health messages not only within the health sector, but across the non-health sectors as well.
You are writing a book for parents. What are some of the main lessons and tips you share? How can parents mitigate the effects of difficult situations they may have to navigate for the sake of their children? When and how can we get the book?
The book will be published in late 2019. The book teaches the reader about the eight resiliency factors practiced by the centenarians and step-by-step guidance for putting these principles into practice with their own families. You can sign up to receive information about the book on my website. Additionally, included on the website is advice from centenarians for parents interested in raising resilient children.
From the book here are three of the top five tips for one of the eight resiliency principles:
Centenarians’ Early Childhood Guide for Living Active in Nature:
- Be active outdoors each and every day, with some time spent that is not at a frenetic sport pace.
- Experience the outdoor elements at different times of the day and in different seasons.
- Develop a purpose for getting outdoors (however small or large: like farming or gardening) to encourage physical interaction with natural elements (like dirt or farm animals).
How else do you hope to share your research findings?
I hope to share my research not only through the book for parents (and grandparents too!), but also a line of children’s picture books linked to this original parent book, workshops to help parents put the wisdom of centenarians into practice and keynote speaking events wherever I can share the message. Anyone interested can email me.
In addition to books and speaking engagements, one of my dreams is to develop a drop-in arts exploration space for children and their families featuring an open studio, art classes and arts exploration rooms, founded on the wisdom of our Blue Zone centenarians. The purpose of the children’s center is to educate our own Adventist community and the non-Adventist community about these resiliency factors and to encourage putting them into practice.
Through my research, I not only interviewed centenarians and seniors, but young Adventist families as well. When I analyzed the data, I was concerned that the values and practices of the centenarians have drastically changed and are no longer practiced by our younger generation. My hope is to bring awareness and increase these practices again.
What other research on this topic do you propose to do?
I am currently working with the other Blue Zone regions to develop an ongoing research study to help promote health and resilience in children worldwide. Up to now, I have funded all of my research looking into the Blue Zone centenarians myself. I am hoping to develop a line of research supported by external grant funding. I am also looking to develop interventions founded on the centenarian resiliency factors.
What has your research in the past primarily focused on?
In the past, my research has focused on the impact of air pollution on vulnerable populations, including children and kidney transplant recipients. This research inspired me to want to help these populations to mitigate the potential damage from pollution exposure.
Interestingly enough, our centenarians in the Loma Linda Blue Zone have lived on average 50 years here in Loma Linda, which has at times poor air quality and in the past even poorer air quality. Yet, despite the poor air quality, these centenarians have been able to live a long and resilient life, potentially a signal of the strength of their resiliency factors that they practice in promoting whole health.
How did you get into your profession? Can you explain your career path briefly?
During my undergraduate years I was interested in becoming a physician. Not accepted right away into medical school, I moved to Loma Linda and enrolled in the School of Public Health to increase my chances of getting in medical school. While obtaining my masters degree I also worked at the San Bernardino County public health department as an epidemiologist tracking diseases. In the end, I did get accepted into a medical school in Iowa, but by then I had really fallen in love with public health. I went on to pursue a doctoral degree and then a postdoc experience at University of Southern California, before coming back to Loma Linda University as a research professor.
What do you most like about your work? What do you find the most challenging?
I really enjoy my work especially the flexibility and the creativity I am afforded. I also really like working with the students and also working with the community on various service and research projects. Most challenging for my work is finding grant funding for research.
Rhonda Spencer-Hwang is Associate Professor in the Center for Community Resilience in the School of Public Health at Loma Linda University. She is an epidemiologist with a master’s and a doctorate degree in Public Health from Loma Linda University. Her undergraduate degree is in biology from Concordia University in Portland, Oregon.
Photo courtesy of Rhonda Spencer-Hwang.
Alita Byrd is interviews editor for Spectrum.
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