Adverse childhood experiences (ACE's)
In the 1980s, the dropout rate of participants at Kaiser Permanente's obesity clinic in San Diego, California, was about 50%; despite all of the dropouts successfully losing weight under the program. Vincent Felitti, head of Kaiser Permanente's Department of Preventive Medicine in San Diego, conducted interviews with people who had left the program, and discovered that a majority of 286 people he interviewed had experienced childhood sexual abuse. The interview findings suggested to Felitti that weight gain might be a coping mechanism for depression, anxiety, and fear. Felitti and Robert Anda from the Centers for Disease Control and Prevention (CDC) went on to survey childhood trauma experiences of over 17,000 Kaiser Permanente patient volunteers.
The document on the left shows the 10 questions to assess the total ACE's and their health impacts in bar charts: Alcoholism, Chronic depression, Domestic violence, Liver disease, Smoking, Susceptibility to being raped, Suicide attempts, Sexual behaviors, Impaired work performance and COPD (Chronic obstructive pulmonary disease). It is seen that for every additional ACE there is a corresponding increase in the health impact.
ACEs - Infographic - CDC.pdfACE's Study (1995 to 1997) - Info graphic - CDC
- Who were covered? 17,000+ cross section of middle class Americans,in California, ages 19 to 60+, 75% with some college or higher education, 75% white.
- How common were the ACE's: 12.5% had 4 or more ACE's, 9.5% had 3 , 16% had 2, 26% had one. 66% had at least one ACE.
- Types of ACE's were: Abuse, Household challenges and Neglect.
- Effects on health were: Severe obesity lack of physical activity, Diabetes, Smoking, Depression, Alcoholism, Suicide attempts, Drug use, STD's, Missed work, Heart disease, Cancer, Stroke, COPD, Broken bones
- People with 6 or more ACE's died 20 years earlier than those who had none.
- Lifetime cost was $124 Billion for: Productivity loss, Health care costs, Special education, Child welfare and Criminal justice.
- ACE's study is continuing. More states are carrying it out.
Prevention and treatment of 'Adverse Childhood Experiences (ACE's)' - Tedx talk
16 Minutes - 78000+ views Childhood trauma isn’t something you just get over as you grow up. Pediatrician Nadine Burke Harris explains that the repeated stress of abuse, neglect and parents struggling with mental health or substance abuse issues has real, tangible effects on the development of the brain. This unfolds across a lifetime, to the point where those who’ve experienced high levels of trauma are at triple the risk for heart disease and lung cancer. Visit the speaker's website Center for Youth Wellness to see her pioneering work in this area. Aces - The childhood adversity naratives - Slides.pdfOpportunities To Change The Outcomes Of Traumatized Children - Slide Show
Books
'The Deepest Well: Healing the Long-Term Effects of Childhood Adversity ' By Nadine Burke Harris MD
Online resources
Center for youth wellness: To improve the health of children and adolescents exposed to Adverse Childhood Experiences (ACEs)
We All Have A Role in Preventing ACEs Training modules
Seven Early Experiences with Potential Benefits in Adulthood
ACEs and Toxic Stress: Frequently Asked Questions - Harvard Center for Child Development
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