Early life experience and environmental context “gets under our skin,” playing a role instress reactivity and affecting health over one’s life (Corburn, 2017; McEwen, 2012; Shonkoff et al., 2012). The body’s physiological response to strong, frequent, or prolonged adversity in the absence of supportive adult relationships during childhood development is toxic stress (Shonkoff et al., 2012). It can result in impaired development that impacts health and wellbeing over the life course (Burke Harris, 2018; Center on the Developing Child at Harvard University, n.d.; Purewal Boparai et al., 2018; Shonkoff et al., 2012). Increased likelihood of chronic conditions such as diabetes and hypertension, increased likelihood of mental health issues such as depression and anxiety, and the development of negative coping mechanisms are associated with toxic stress (Burke Harris, 2018; Center on the Developing Child at Harvard University, n.d.; Purewal Boparai et al., 2018; Shonkoff et al., 2012).

A growing body of literature recognizes the need for greater exploration of toxic stressoutside of clinical and social service settings, a movement upstream to situate toxic stress research in an ecological context (Burke Harris, 2018; Corburn et al., 2014; Ellis & Dietz, 2017; Shonkoff et al., 2012). My dissertation research is part of this growing area of toxic stress research. In this dissertation, I have three aims: 1) to identify concepts and frameworks in the academic and professional literature that situate toxic stress within an ecological context, 2) to understand toxic stress and healing at the community level through a case study of a community-driven process as collective healing, and 3) to explore youth perspectives of and experiences with toxic stress and adversity. I will achieve these aims through the completion of a narrative literature review, case study, and youth Photovoice project.