The Buildings You Design Don't Know It — But Some of Them Are Making Children Sick
By Dr. Pamela J. Pine
In 2023, the American Planning Association published a formal practice guide on trauma-informed planning. For public health professionals who have been working in this space for decades, it felt like a long-overdue welcome.
For the planners reading that guide, I suspect it felt like a new idea. Let me make it real.
Adverse childhood experiences — ACEs — are defined by the Centers for Disease Control and Prevention as all types of abuse, neglect, and other traumatic experiences that occur to youth under the age of 18. They include exposure to domestic violence, substance use in the home, sexual abuse, economic hardship, and more. They affect more than 60% of U.S. adults. And the research is now unambiguous: physical aspects of a neighborhood — lighting, traffic density, noise, and greenspace — may either trigger trauma or promote healing for individuals and communities who carry these histories.
This is not a metaphor. It is a documented, peer-reviewed finding with direct implications for public policy and urban planning.
Consider what it means in practice. A playground without adequate lighting and clear sightlines is not just underutilized — it is a space that a parent who survived sexual violence cannot bring her children to without experiencing the fear response that her ACE history installed in her nervous system. A transit stop in a noisy, chaotic, visually overwhelming environment is not just inconvenient — it is a space that re-traumatizes residents with PTSD from childhood exposure to violence. A housing development designed without community input from residents who have repeatedly experienced displacement is not just a planning oversight — it causes what researcher Mindy Fullilove calls “root shock,” a traumatic stress response to the forced loss of community that produces measurable increases in depression, substance use, and mortality.
These connections are not theoretical. They are operational. And they are present in every planning decision made across the Mountain-Plains West, from urban redevelopment projects to small-town comprehensive plans to tribal land management decisions.
The communities with the highest ACE burdens are the communities that planners in the Western planning region are most often being asked to serve. Rural communities, where geographic isolation and economic volatility create conditions that generate ACEs faster than limited mental health resources can address them. Tribal communities, where historical trauma has compounded generations of childhood adversity. Urban neighborhoods shaped by decades of disinvestment, discriminatory housing policy, and concentrated poverty.
Trauma-informed planning does not require planners to become therapists. It requires them to understand what the people in their communities are carrying — and to design the physical environments, the engagement processes, and the policy frameworks that either honor or disregard that knowledge.
The APA has given the field a name. The research has given it a foundation. What it needs now are planners who understand it deeply enough to practice it.
The buildings you design don't know it. But some of them are making children safer. And some of them are not.
It's time to know the difference.
About the Author
Dr. Pamela J. Pine, CFRE, is the Founder and Director of Stop the Silence®, a department of the Institute of Violence, Abuse and Trauma (IVAT), and an internationally recognized public health expert in adverse childhood experience prevention, trauma-informed community design, and community resilience.