What is the Adverse Childhood Experience Study?

The original Adverse Childhood Experience Study or ACEs was conducted between 1995 and 1997. It was a collaboration between the Centers for Disease Control and Violence Prevention (CDC) and Kaiser Permanente. According to the CDC, ACEs was one of the largest scientific research studies with two waves of data collection. Over 17,000 Health Maintenance Organization members from Southern California receiving physical exams completed confidential surveys regarding their childhood experiences and current health status and behaviors. The CDC continues ongoing surveillance of ACEs by assessing the medical status of the study participants via periodic updates of disease and mortality data.

The relationship between childhood trauma and the risk for physical and mental illness in adulthood was the focus of the study. What constituted childhood trauma was broken down into a list of 10 categories. They included: recurrent physical abuse, recurrent emotional abuse, contact sexual abuse, an alcohol and/or drug abuser in the household, an incarcerated household member, family member who is chronically depressed, mentally ill, institutionalized, or suicidal, mother is treated violently, one or no parents, physical neglect and emotional neglect. The data showed a sound relationship between the traumatic stress level in childhood and poor physical, mental and behavioral later in life.

Formulated into a pyramid, the data was broken down into tiers. The bottom tier represented the ACE Study. The next tier represented Social, Emotional and Cognitive Impairment. Above that was Adoption of Health Risk Behaviors, followed by the tier of Disease, Disability and Social Problems. The peak of the pyramid was Early Death.

According to the CDC, youth violence is a major public health issue for both individuals and communities. Each year, more than 4,000 young people between the ages of 15 and 24 die by homicide, making homicide the third leading cause of death for this age group. CDC’s Division of Violence Prevention funds several National Centers of Excellence in Youth Violence Prevention (formerly Academic Centers of Excellence). Protecting our youth from violence can lead to healthier adults with greater purpose.

The Substance Abuse and Mental Health Services Administration notes that preventing adverse childhood experiences, and the early identification of them could have a significant impact on a range of critical health problems. By collecting state- and county-level ACEs data, increasing awareness of substance abuse and behavioral problems, including ACEs among the primary risks and protective factors in prevention planning, finding and implementing programs to reduce intergenerational trauma, and using local ACEs data to identify groups at higher risk for substance abuse and mental disorders provides invaluable data for prevention.

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