Adverse Childhood Experiences (ACEs)

ACEs are becoming the latest things children should avoid. “ACEs are strongly related to development of risk factors for disease, and well-being throughout the life course.” We need to normalize mental health supports at schools and the community because ACEs don’t just happen to children, they happen to everyone. This year, our community participated in producing a Community Foundations of Canada Community Report so we could worked on our ACEs. Learn more about ACEs.

 

The ACE Pyramid

The ACE Pyramid represents the conceptual framework for the ACE Study. The ACE Study has uncovered how ACEs are strongly related to development of risk factors for disease, and well-being throughout the life course.

	Image shows a six-level pyramid to represent mechanisms by which adverse childhood experiences influence health and well-being throughout the lifespan. An arrow pointing upward is at the left of the pyramid. At bottom of the arrow is the word “conception;” at top is “death.” From the bottom up, the base of pyramid base of pyramid reads “Adverse Childhood Experiences.” Next level up reads “Disrupted Neurodevelopment.” Third level at middle of pyramid reads “Social, Emotional, and Cognitive Impairment.” Level four of the pyramid is Adoption of Health-risk Behaviors. Level five is Disease, Disability, and Social Problems. Level six at the top of the pyramid reads “Early Death.”

 

 

Data and Statistics

Adverse Childhood Experiences (ACEs) are categorized into three groups: abuse, neglect, and family/household challenges. Each category is further divided into multiple subcategories. Participant demographic information is available by gender, race, age, and education. The prevalence of ACEs is organized by category.

ACEs Definitions collapsed

All ACE questions refer to the respondent’s first 18 years of life.

  • Abuse
    • Emotional abuse: A parent, stepparent, or adult living in your home swore at you, insulted you, put you down, or acted in a way that made you afraid that you might be physically hurt.
    • Physical abuse: A parent, stepparent, or adult living in your home pushed, grabbed, slapped, threw something at you, or hit you so hard that you had marks or were injured.
    • Sexual abuse: An adult, relative, family friend, or stranger who was at least 5 years older than you ever touched or fondled your body in a sexual way, made you touch his/her body in a sexual way, attempted to have any type of sexual intercourse with you.
  • Household Challenges
    • Mother treated violently: Your mother or stepmother was pushed, grabbed, slapped, had something thrown at her, kicked, bitten, hit with a fist, hit with something hard, repeatedly hit for over at least a few minutes, or ever threatened or hurt by a knife or gun by your father (or stepfather) or mother’s boyfriend.
    • Household substance abuse: A household member was a problem drinker or alcoholic or a household member used street drugs.
    • Mental illness in household: A household member was depressed or mentally ill or a household member attempted suicide.
    • Parental separation or divorce: Your parents were ever separated or divorced.
    • Criminal household member: A household member went to prison.
  • Neglect1
    • Emotional neglect: Someone in your family helped you feel important or special, you felt loved, people in your family looked out for each other and felt close to each other, and your family was a source of strength and support.2
    • Physical neglect: There was someone to take care of you, protect you, and take you to the doctor if you needed it2, you didn’t have enough to eat, your parents were too drunk or too high to take care of you, and you had to wear dirty clothes.

1Collected during Wave 2 only.

2 Items were reverse-scored to reflect the framing of the question.

 

Major Findings

Adverse Childhood Experiences (ACEs) are common. Almost two-thirds of study participants reported at least one ACE, and more than one in five reported three or more ACEs.

The ACE score, a total sum of the different categories of ACEs reported by participants, is used to assess cumulative childhood stress. Study findings repeatedly reveal a graded dose-response relationship between ACEs and negative health and well-being outcomes across the life course.

As the number of ACEs increases so does the risk for the following*:

Dose-response describes the change in an outcome (e.g., alcoholism) associated with differing levels of exposure (or doses) to a stressor (e.g. ACEs). A graded dose-response means that as the dose of the stressor increases the intensity of the outcome also increases.

  • Alcoholism and alcohol abuse
  • Chronic obstructive pulmonary disease
  • Depression
  • Fetal death
  • Health-related quality of life
  • Illicit drug use
  • Ischemic heart disease
  • Liver disease
  • Poor work performance
  • Financial stress
  • Risk for intimate partner violence
  • Multiple sexual partners
  • Sexually transmitted diseases
  • Smoking
  • Suicide attempts
  • Unintended pregnancies
  • Early initiation of smoking
  • Early initiation of sexual activity
  • Adolescent pregnancy
  • Risk for sexual violence
  • Poor academic achievement

*This list is not exhaustive. For more outcomes see selected journal publications.

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