What is ACE?
The Adverse Childhood Experiences (ACEs) study, indeed, has had profound implications for understanding the long-term impacts of childhood adversity on health and well-being. This large-scale, collaborative research project between the Centers for Disease Control and Prevention (CDC) and Kaiser Permanente started in the late 1990s, involving over 17,000 participants. It explored the relationships between 10 types of childhood stressors and a variety of physical, mental, and social outcomes.
The 10 ACEs are typically categorized into three main areas:
Abuse:
- Physical abuse
- Emotional abuse
- Sexual abuse
Neglect:
- Physical neglect
- Emotional neglect
Household dysfunction:
- Substance abuse in the household
- Mental illness in the household
- Domestic violence (witnessing a mother or stepmother being treated violently)
- Parental separation or divorce
- Incarceration of a household member
The study found that these adverse experiences are not only common but also interrelated, meaning children who experience one form of adversity are likely to experience others. Moreover, the cumulative effect of multiple ACEs has been shown to significantly increase the risk of numerous health and social issues in adulthood, including:
- Chronic health conditions (e.g., heart disease, diabetes)
- Mental health problems (e.g., depression, anxiety, PTSD)
- Substance abuse and addiction
- Social and behavioral issues (e.g., violence, incarceration)
- Premature death
One of the key takeaways is the concept of a “dose-response” relationship: the more ACEs a person experiences, the greater their risk of developing various health issues.
This research highlights the importance of early intervention and trauma-informed care to mitigate the long-term consequences of childhood adversity. It also emphasizes the need for broader social and public health initiatives to address the underlying causes of ACEs, such as poverty, inequality, and lack of access to mental health services.