ACEs and Healthcare

Creating a Positive Future

Abstract

The adverse childhood experiences (ACEs) study represents a landmark in medical research which linked childhood experiences of abuse, neglect, and household dysfunction to future health outcomes. (Cronholm, Forke, Wade, Bair-Merritt, Davis, Harkins-Schwarz, Pachter & Fein, 2015). Felitti and colleagues (1998) conducted the original ACEs study in a primary care setting between 1995-1997 at a Kaiser Permenante clinic where thousands of participants revealed they had adverse childhood experiences (Felitti, Anda, Nordenberg, Willliamson, Spitz, Edwards, Koss, & Marks, 1998).  This original study found a strong dose response relationship between the extent of exposure to abuse or household dysfunction during childhood and multiple risk factors for several leading causes of death in adults. These conditions included: ischemic heart disease, cancer, chronic lung disease, fractures, liver disease as well as poor self-rated health (Felitti et al, 1998). Felitti et al, (1998) suggested ACEs and adult health status is strong and cumulative. They further asserted that abuse and other potentially damaging childhood experiences contribute to the development of risk factors leading to health behaviors and lifestyle factors that affect morbidity and mortality. These behaviors they allege are the “actual” cause of death (Felitti et al, 1998).