Community Spotlight: Dr. Mikah Owen

Community Spotlight: Mikah Owen, MD, MPH, MBA
Director of Clinical and Academic Programs and Health Equity, UCAAN

Based in the Sacramento area​, Dr. Owen is a social pediatrician who has dedicated his career to improving the health and well-being of children and adolescents from marginalized and vulnerable backgrounds, especially those with involvement in the child welfare and juvenile justice systems.

Dr. Owen has been a long-time adviser to the ACEs Aware initiative and recently joined the UCLA-UCSF ACEs Aware Family Resilience Network (UCAAN) as Senior Director of Clinical and Academic Programs, and Health Equity. Prior to joining UCAAN, Dr. Owen was an Assistant Clinical Professor in the Department of Pediatrics at UC Davis Health​.

Dr. Owen earned an MD at UCSF, completed his Pediatric Residency at UC Davis, and completed his fellowship in Community and Societal Pediatrics at the University of Florida College of Medicine – Jacksonville.​ He recently completed the Pozen-Commonwealth Fund Fellowship in Health Equity Leadership at Yale University​.

What inspired you to become a social pediatrician?

In medical school, I pursued a dual-degree program, so after finishing my third year of medical school I enrolled in a Master’s in Public Health program at UC Berkeley. During the program, I learned a lot more about social and life-course epidemiology and I gained foundational knowledge about the determinants of health and well-being. I really came to understand that the environment and experiences of childhood have a profound impact on the health and well-being of individuals, communities, and, ultimately, society. To establish a healthier population and eliminate inequities in health and well-being, we must establish a clinical, community, and policy environment in which all children, especially those from marginalized communities and backgrounds, have an equitable chance to achieve their full potential. I chose to pursue a career in pediatrics because I believed it would afford me the opportunity to advocate for such an environment.

Social pediatrics may be defined as “an approach to child health that focuses on the child, in illness and in health, within the context of their society, environment, school, and family”. Over the course of my medical education and training, it become really obvious that the challenges my patients and families were facing could not be solved in the clinic. I wanted to learn more about how community, social, and policy environments influenced the health and well-being of children and adolescents. I also wanted to learn how I could strengthen my advocacy efforts and focus not only on direct clinical care, but also on systems change and designing systems of care that support children and adolescents. My fellowship training is in community and societal pediatrics, and it aims to train clinicians to consider the intersections between clinical medicine, public health, children’s rights, and public policy.

How did you become passionate about addressing Adverse Childhood Experiences (ACEs) and trauma-informed care?

In hindsight, I think I was passionate about ACEs and childhood adversity before I even knew how to define them.

From the beginning, I approached my medical education and training from a health equity perspective. Before starting medical school, I had a general understanding of inequities in health and well-being, especially among Black people and Black communities in the United States. I knew that I wanted to pursue a career that gave me the opportunity to try to address these inequities.

Inherently, growing up as a Black child, I also understood that many of these inequities are anchored in childhood. I, like many Black children, was taught from a young age that mistakes in childhood could be magnified and change the trajectory of my whole life. I was taught that our society’s systems and policies do not treat Black children fairly and that Black children often face harsher consequences. This knowledge and understanding help to guide my career decisions. I knew I wanted my clinical and advocacy activities to be anchored in supporting children and adolescents who had faced challenging life circumstances. This led me to become involved in clinical and advocacy efforts focused on youth with involvement (or at risk of involvement) with the juvenile justice system.

As I worked to improve my knowledge and skills around supporting my patients, I learned more about the science of ACEs and adversity and began to better understand the pervasive impact of ACEs, childhood adversity, and toxic stress. As I learned more and improved my clinical skills, I realized that virtually all of my patients with juvenile justice involvement had been exposed to significant and sustained adversity from a young age. I also realized that to provide the best care for my patients, I had to learn how to better communicate the impact of cumulative adversity to patients and families, help patients and families mitigate the impact of toxic stress, and advocate for a clinical, community, and policy environment that works to prevent ACEs and toxic stress and works to support the needs of children, families, and communities that are impacted by ACEs, adversity, and toxic stress.

How does addressing ACEs help to overcome health care disparities?

I believe that addressing ACEs and toxic stress is necessary but insufficient to overcome health inequities.

It’s necessary because health inequities, ACEs, childhood adversity, and structural racism and discrimination are all interrelated. Racism and the resulting systemic inequities create the conditions that lead to the inequitable distribution and impact of ACEs. Therefore, it’s really important to understand the intersection between ACEs and health disparities and work to identify ACEs and respond to toxic stress, especially in individuals and communities that are disproportionately impacted by ACEs and health inequities.

At the same time, we know that identifying ACEs and responding to toxic stress alone will not eliminate health inequities. The pervasive impact of racism, discrimination, and other structural inequities requires a robust, comprehensive, multi-sectoral response. We must partner and collaborate with patients, communities, and other sectors. I think that is what’s so exciting — not just the work that’s being done on ACEs and toxic stress, but health care across California. I think there’s more recognition that this work must occur across sectors. There’s more recognition of some of the social and structural determinants, including racism and discrimination, and how it’s impacted people’s lives across generations. I think there’s more interest, passion, and effort that’s being made to say, “How do we undo some of the historical and ongoing harms done to individuals and communities?” Identifying ACEs and risk of toxic stress is an important part of that. However, we must emphasize that it’s only a part of it; it also needs to be done along with community engagement, community development, workforce development, and broader work that’s being done for health equity in California.

Knowing that we’re a part of a greater whole in California, with the Children and Youth Behavioral Health Initiative, California Office of Health Equity, the Reparations Task Force, etc., is what’s really exciting about being here, doing this work at this time. I feel more optimistic about the future of our kids.