Adverse Childhood Experiences (ACEs) are potentially traumatic events that occur in childhood. ACEs can include violence, abuse, and growing up in a family with mental health or substance use problems. Toxic stress from ACEs can change brain development and affect how the body responds to stress. ACEs are linked to chronic health problems, mental illness, and substance misuse in adulthood. However, ACEs can be prevented.
A first-ever CDC analysis provides comprehensive estimates of the potential to improve Americans’ health by preventing Adverse Childhood Experiences (ACEs).
ACEs can include experiencing abuse, witnessing violence or substance misuse in the home, and having a parent in jail. Exposure to ACEs can result in extreme or repetitive toxic stress responses that can cause both immediate and long-term physical and emotional harms.
At least five of the top 10 leading causes of death are associated with ACEs. Preventing ACEs could potentially reduce chronic diseases, risky health behaviors, and socioeconomic challenges later in life.
These findings appear in CDC’s latest Vital Signs report, which examines the associations between ACEs and 14 negative outcomes. CDC analyzed data from 25 states that included ACE questions in the Behavior Risk Factor Surveillance System (BRFSS) from 2015 through 2017. State survey data were used to estimate long-term health and social outcomes in adults that contribute to leading causes of illness and death and reduced access to life opportunities.
Key findings
- Adults reporting the highest level of ACEs exposure had increased odds of having chronic health conditions, depression, current smoking, heavy drinking, and socioeconomic challenges like current unemployment, compared to those reporting no ACEs.
- Women, American Indian/Alaskan Natives, and African Americans/Blacks were more likely to experience four or more ACEs.
- Preventing ACEs could have reduced the number of adults who had heart disease by as much as 13% – up to 1.9 million avoided cases, using 2017 national estimates.
- Preventing ACEs could have reduced the number of adults who were overweight/obese by as much as 2% – up to 2.5 million avoided cases of overweight/obesity, using 2017 national estimates.
- Preventing ACEs could have reduced the number of adults with depression by as much as 44% – up to 21 million avoided cases of depression, using 2017 national estimates.
Potential Reduction of Negative Outcomes in Adulthood
Adverse Childhood Experiences impact lifelong health and opportunities. ACEs are common and the effects can add up over time.
- 61% of adults had at least one ACE and 16% had 4 or more types of ACEs.
- Females and several racial/ethnic minority groups were at greater risk for experiencing 4 or more ACEs.
- Many people do not realize that exposure to ACEs is associated with increased risk for health problems across the lifespan.
The Way Forward
Healthcare Providers Can:
- Anticipate and recognize current risk for ACEs in children and history of ACEs in adults. Refer patients to effective services and support.
- Link adults to family-centered treatment approaches that include substance abuse treatment and parenting interventions.
Employers Can:
- Adopt and support family-friendly policies, such as paid family leave and flexible work schedules.
States and Communities Can:
- Improve access to high-quality childcare by expanding eligibility, activities offered, and family involvement.
- Use effective social and economic supports that address financial hardship and other conditions that put families at risk for ACEs.
- Enhance connections to caring adults and increase parents’ and youth skills to manage emotions and conflicts using approaches in schools and other settings.
Everyone Can:
- Recognize challenges that families face and offer support and encouragement to reduce stress.
- Support community programs and policies that provide safe and healthy conditions for all children and families.
Source: Centers for Disease Control and Prevention | Adverse Childhood Experiences (ACEs), Preventing early trauma to improve adult health, https://www.cdc.gov/vitalsigns/ACEs | public domain, Page last reviewed: November 5, 2019
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