The Other Side of the ACEs Pyramid: A Healing Framework for Indigenous Communities

For over two decades, extensive research has demonstrated significant associations between adverse childhood events (ACEs) and a wide range of negative health, mental health, and social outcomes. For Indigenous communities globally, colonization and historical trauma are commonly associated with ACEs, and these effects reverberate through generations. While the ACEs conceptual framework expanded pyramid is a useful model and a visual aid for understanding the historical and present-day dimensions of ACEs in Indigenous communities, a healing conceptual framework is needed to outline a path toward increased community well-being. In this article, we provide a holistic Indigenous Wellness Pyramid that represents the other side of the ACEs pyramid to guide pathways toward healing in Indigenous communities. In this article, the authors describe the Indigenous Wellness Pyramid according to each of the following contrasts with the ACEs pyramid: Historical Trauma-Intergenerational Healing/Indigenous Sovereignty; Social Conditions/Local Context-Thriving Economic and Safe Communities; ACEs-Positive Childhood, Family, and Community Experiences; Disrupted Neurodevelopment-Consistent Corrective Experiences/Cultural Identity Development; Adoption of Health Risk Behaviors-Cultural Values and Coping Skills; Disease Burden and Social Problems-Wellness and Balance; Early Death-Meaningful Life Longevity. We provide examples, supporting research, and implications for implementing the Indigenous Wellness Pyramid.