ACES: The Surprising Link Between Child Abuse and Adult Wellness

April is Child Abuse Prevention Month, and as a result, our team at Alliance Healthcare Foundation (AHF) has had childhood health and well-being at the top of our minds these past few weeks. As Dr. Robert Block, former President of the American Academy of Pediatrics, aptly noted: “Adverse childhood experiences are the single most unaddressed public health threat facing our nation today.”

In light of that, this month seems like an opportune time to share emerging research around the subject of Adverse Childhood Experiences, also known as ACES, and how these experiences ultimately strain our healthcare system.

What is ACES?

The ACE Study is one of the largest and most comprehensive studies to date that investigates the relationship between adverse childhood experiences and what influence it may have on one’s health later in life.

Conducted by Kaiser Permanente in partnership with the U.S. Centers for Disease Control and Prevention, this study examines multiple categories of childhood abuse, including physical abuse, emotional abuse, as well as neglect. The study also takes into consideration levels of household dysfunction, including domestic violence, parental mental illness, substance abuse, and divorce.

What does ACES reveal about health?

The findings of the original ACES study concluded that ACES are incredibly common—as much as 67%, or two thirds, of people have at least one ACE, while 13% had four or more.

“Secondly, there was a dose-response relationship between ACEs and numerous health problems. This means that the more ACEs a child has, the higher the risk of developing chronic illnesses such as heart disease, chronic obstructive pulmonary disease (COPD), depression and cancer.”   – Center for Youth Wellness

Subsequent research has confirmed these findings. A wide range of challenges, from social stressors at school to stressors that may be a regular part of home life, all play a role.

Our particular concern here are chronic stressors. Unlike temporary stressors, toxic stress has the capacity to change the architecture of developing brains and organ systems, priming these individuals for emotional, psychological, and health challenges later on in life.

What is the link between childhood trauma and healthcare costs?

The Federal Centers for Disease Control and Prevention recently presented findings that suggest a strong correlation between U.S. healthcare costs and the instance of childhood trauma:

• “the total lifetime financial costs associated with just one year of confirmed cases of child maltreatment … is approximately $124 billion

• “the lifetime cost for each victim of child maltreatment who lived was $210,012 — comparable to the costs for patients who had strokes or type 2 diabetes.”

This data creates a strong case that by addressing childhood trauma early on, as well as looking at how trauma may be affecting an adult’s physical health, has the potential to create billions of dollars in healthcare-related savings each year.

Screening and Prevention

“The science is clear: early adversity dramatically affects health across a lifetime.”

– Dr. Nadine Burke Harris

For many medical professionals, like Dr. Nadine Burke Harris, this science has fundamentally changed the understanding of the relationship between childhood trauma and overall health.

By implementing effective screening and intervention techniques, we can not only save children from traumatic, damaging experiences, but we can also help our communities prevent individuals from having a lifetime of costly healthcare needs. Preventative care, as well as catching situations early, are key to helping individuals lead healthier lives and alleviating a substantial financial burden from the healthcare sector.

Interrupting the progression of early adversity by identifying children who have a high ACE score is a proactive step that can be implemented today, in various ways.

AHF Grantees (Past and Present) Working to Address Childhood Trauma

Our own grantees have done much work related to these issues.  

• Home Start – Committed to creating a community-focused effort to reach families with children who are at risk for abuse or neglect, Home Start works directly with families to help them identify ways to build a better future.

• Voices for Children – Seeks to transform the lives of children who have been abused by providing them with Court Appointed Special Advocates.

• Court Appointed Special Advocate Imperial County, (CASA) – Provides trained community volunteers to work with children who have been abused or neglected in court. These individuals follow each child’s case through the court system to help them navigate through foster care.

• CAP Council in Imperial – Strives to create a statewide network of supporters, including public policymakers and collaborative agencies who work together to prevent child abuse and neglect. They do this by monitoring and working to influence public policy and programs that seek to protect children.

Calculate your ACES Score

If you’re curious about how ACES works, you can calculate your own ACES score. Once you have your score, explore the rest of that article for follow-up actions or utilize a local resource, such as past AHF grantee Center for Community Solutions.

Ultimately, the ACES study and the grantees listed above are all working toward a common goal: We must find ways to better protect our children, especially those in at-risk communities. This begins with transforming the way our healthcare system responds to their challenges, looking at symptoms early on, and working to create change long before these experiences manifest as illnesses later in life.

Interested in knowing more about ACES? Leave us a comment on Facebook or send us a tweet @AllianceHF to continue the conversation. We’d love to hear your thoughts, answer your questions, or provide resources as needed.

-Nancy Sasaki, Executive Director
Alliance Healthcare Foundation
NSasaki@AllianceHF.org

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About Alliance Healthcare Foundation

Alliance Healthcare Foundation is a San Diego-based nonprofit which works with nonprofit, government and community agencies to advance health and wellness throughout the San Diego and Imperial Counties. AHF works to serve the most vulnerable – the poor, working poor, children and homeless by providing grants, advocacy and education to support its region.

To learn more about AHF, visit:   AHF on Facebook, AHF on LinkedIn, AHF on Google+, AHF on YouTube, AHF on Twitter

To learn more about our grantees, visit our Grantee Page.