During the mid 1990’s, the MD of Kaiser Permanente Medical Care Program, a US based Health Maintenance Organisation Vincent J. Felitti and MD of the CDC Dr. Robert Anda conducted a study with over 17.000 patients for a two year period to delve into 8 different potential categories of childhood/household instability or abuse to view the relationship it may have later on in adulthood. Although their research dated back to the 1980’s due to Dr Felitti wanting to further explore why there were a large number of drop-outs from his obesity clinic, despite significant progress being made, the mid 90’s proved valuable for the future of healthcare. The study will be referred to as the ACE study, with ACE standing for Adverse Childhood Experience.
What 8 categories were studies as ACE?
1) Recurring physical abuse
2) Recurring emotional abuse
3) Sexual abuse
4) Growing up in a household where a member of the family was involved with the judiciary services
5) Where the mother was treated violently
6) Where there was a member of the household who was dependant on alcohol/substances
7) Where there was a member of the household who was chronically depressed, mentally ill, or suicidal
8) Where at least one biological parent was lost to the patient during childhood – regardless of cause
If an individual had experienced any of the above, they would be scored with a point for each subject they had experienced.
The research proved shocking with 2 out of 3 individuals in the study having at least 1 ACE, and 1 in 8 having more than half of all ACE’s and those one in 8 individuals were seen to have increased risk of developing certain healthcare conditions and lifestyle habits ranging from cancer and depression to smoking and physical violence.
See the below graph for further information
Source: Connected For Life ACE Study
The shocking findings continued, with research showing that those with 6 ACE’s or more, were more likely to die 20 years younger when compared to someone with 0 ACE’s.
It is important to take social factors, genetics, geographical location, gender, age, education levels and further diversities into factor, as the original ACE study was found to focus prominently on cisgender middle aged, college educated white males; so as this study has been further replicated globally, the numbers in the ratios as above have changed significantly.
For example, Bellis et al conducted the English and Welsh studies in 2014 and 2015 and found that;
- In England, almost half of the entire adult population was found to have at least one ACE
- In England, 1 in every 12 adults had more than 4 ACE’s.
- These numbers were slightly higher in Wales.
Whilst studies in the US have shown that;
- ACEs were highest among females, non-Hispanic American Indian or Alaska Native adults, and adults who were unable to work/out of work
- Nearly 1 in 6 US citizens, as opposed to the one in 12 in England, were found to have 4 or more ACEs.
- Estimates show up to 1.9 million heart disease cases and 21 million depression cases potentially could have been avoided by preventing ACEs
With my previous discussions and support of holistic care, the ACE’s study once again solidifies that the body will not be whole without appropriate mental health care.
The ACE’s have since been expanded following the research to include traumas such as loss of a parent, or parental separation, which we may argue sometimes is inevitable, or there are some things that may seem like the healthier option at the time, such as smoking in instance, as mentioned above, to try and maintain stability.
Life cannot be skipped and the importance here lies in being able to learn how to understand, communicate and regulate the emotions that may be caused by these ACE’s.
It’s also important note that merely knowing the existence of the ACE Study may bring comfort to those who have struggled to make sense of or validate their trauma internally.
Regardless of how much of it is remembered, how new or old it is, how many times it has occurred, trauma is valid and impacts us from our earliest days, whilst possibly being the reasons for our last, and prematurely at that; so what can we do as individuals and as a society to break the cycle of ACEs and create a more supportive environment for children, and those inner children left untreated for adults with ACEs?
Sources
English (UK) 
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