Adverse Childhood Experiences

Many people can identify a person in their lives who struggles with a chronic illness like heart disease, diabetes, or hypertension. Most people also know someone who struggles with mental illness, substance abuse, or relationships in general. Traditionally, the health care system would point to high-risk behaviors such as poor diet, drug use, or a sedentary lifestyle as the primary causal factors. Questions for patients have focused on “What’s wrong with you?” rather than “What happened to you?”

A 1998 study from the Centers for Disease Control and Prevention (CDC) and Kaiser Permanente is leading to a paradigm shift in the medical community’s approach to disease. This study of more than 17,000 middle-class Americans documented quite clearly that adverse childhood experiences (ACEs) can contribute significantly to negative adult physical and mental health outcomes and affect more than 60% of adults.  This continues to be reaffirmed with more recent studies.

Adverse childhood experiences include

• Emotional abuse

• Physical abuse

• Sexual abuse

• Emotional neglect

• Physical neglect

• Mother treated violently

• Household substance abuse

• Household mental illness

• Parental separation or divorce

• Incarcerated household member

About two-thirds of individuals reported at least one adverse childhood experience; 87% of individuals who reported one ACE reported at least one additional ACE.[4] The number of ACEs was strongly associated with adulthood high-risk health behaviors such as smoking, alcohol and drug abuse, promiscuity, and severe obesity, and correlated with ill-health including depression, heart diseasecancerchronic lung disease and shortened lifespan.[4][8][9] Compared to an ACE score of zero, having four adverse childhood experiences was associated with a seven-fold (700%) increase in alcoholism, a doubling of risk of being diagnosed with cancer, and a four-fold increase in emphysema; an ACE score above six was associated with a 30-fold (3000%) increase in attempted suicide. The ACE study’s results suggest that maltreatment and household dysfunction in childhood contribute to health problems decades later. These include chronic diseases—such as heart disease, cancer, stroke, and diabetes—that are the most common causes of death and disability in the United States The study was initially published in the American Journal of Preventive Medicine