There’s an excellent article in this week’s New Yorker about Nadine Burke and her work at the Bayview Child Health Center. The article focuses on the connection between childhood trauma and adult health problems and cites the ACE Study. (See the article abstract here, full access requires a subscription.)
The ACE Study (Adverse Childhood Experience) describes itself as “Bridging the gap between childhood trauma and negative consequences later in life” and is the “… largest scientific research study of its kind, analyzing the relationship between multiple categories of childhood trauma (ACEs), and health and behavioral outcomes later in life.” It is an ongoing collaboration between the Centers for Disease Control and Prevention and Kaiser Permanente.
The study encompassed more than 17,000 adults and assessed multiple categories of stressful or traumatic childhood experiences:
- Recurrent physical abuse
- Recurrent emotional abuse
- Contact sexual abuse
- An alcohol and/or drug abuser in the household
- An incarcerated household member
- Someone who is chronically depressed,mentally ill, institutionalized, or suicidal
- Mother is treated violently
- One or no parents
- Emotional or physical neglect
More than half of the participants reported at least one type of adverse experience, about 25% reported two, and more than 10% reported 5 or more. ACEs tend to occur in clusters, rather than single experiences.
Researches developed a simple questionnaire that captured an “ACE Score,” which demonstrated a
strong, graded relationship to health, social, and behavioral problems over the course of the person’s life. Among other things, ACEs show a strong influence on mental health, the risk of re-victimization, the stability of relationships, and performance in the workforce. ACES also often indicate an increased rate serious adult health issues: heart disease, chronic lung disease, liver disease, suicide, HIV and STDs, and other risks. In a 5-minute CDC podcast entitled Bad Memories, Dr. Valerie Edwards discusses the lingering effects of adverse childhood experiences.
According to researchers, this demands an “…integrated approach to intervene early on children growing up being abused, neglected, witnessing domestic violence, or with substance abusing, mentally ill, or criminal household members. All of these childhood stressors are interrelated and usually co-occur in these homes. Prevention and treatment of one ACE frequently can mean that similar efforts are needed to treat multiple persons in affected families.”
The integrated approach is one that employers should heed with their employees, as well. It underscores the imperative that any serious wellness program must include a strong behavioral and mental health component since many serious health conditions may be rooted in or exacerbated by ACEs.
The Centers for Disease Control offers much more information about the Adverse Childhood Experiences Study, including a list of related publications.