It’s long been recognized that experiences during childhood shape our perception and understanding of future moments in adulthood. Adverse Childhood Experiences or ACEs was a term coined to describe negative early experiences that dramatically impact later-life health and well-being in adulthood. Initial, foundational research in this field began in 1997 in a study by the CDC and Kaiser Permanente that gathered data on more than 17,000 participants. Questions asked included questions on abuse, neglect, family drug use, parental separation, and sexual assault among others.
The study found that ACEs are highly common, with almost two-thirds of the entire cohort reporting at least one ACE and one in five reporting three or more ACEs. This translates to roughly 34.8 million total children in the US.
Over time these negative experiences disrupt neurodevelopment, lead to social, emotional and cognitive impairment, and ultimately influence the adoption of health-risk behaviors. This then results in higher rates of disease, disability, and early death. The higher exposure to ACEs a patient had, the worse their health and well-being were impacted. In other words, as the number of ACEs increase so does risk for conditions such as ischemic heart disease, alcoholism, suicide attempts, unintended pregnancies, smoking, financial stress, and sexual violence among others. In fact, after controlling for other risk factors, a recent study published in the Journal of the American Medical Association, showed that significant childhood trauma was correlated with worse health outcomes and more cases of adult psychiatric disorders.
Compounding on this, current research shows that the consequences of childhood traumas such as maltreatment, might in fact transmit across generations too. Adverse childhood experiences have also been linked to unmet healthcare needs in already vulnerable populations such as those with ASD, widening existing healthcare disparities.
The good news is that with early intervention and prevention the impacts of ACEs can be mitigated. That’s why it is essential that ACEs be recognized early by the healthcare world. Additionally, in later adulthood, knowing this background can be useful in understanding symptoms and deciding on treatments.
At Trayt, we recognize the importance of gathering these data points and therefore have included a section asking about ACEs and other life stressors. Medicine needs to be personalized and we cannot assume that everyone’s histories and reasons for illness overlap.