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Adverse Childhood Experiences (ACES)

Adverse Childhood Experiences (ACES)

Adverse Childhood Experiences (ACEs) is the term given to describe abuse, neglect, and other traumatic experiences that occur to individuals under the age of 18. In 1998, a landmark ACE study conducted by Kaiser Permanente and the Centers for Disease Control and Prevention (CDC) examined the relationship between adverse experiences during childhood and reduced health and well-being in later life.1 In the study, over 17,000 HMO participants in the San Diego area received physical exams, completed surveys on ACEs, and assessed current health status and behaviors. In the ACE Survey, there are 10 items. Half of the adverse experiences involve abuse (physical, sexual, psychological) and neglect (physical, emotional), and half of the items pertain to household dysfunction (growing up in household affected by substance abuse, mental illness, domestic violence, separation/divorce, and parental incarceration). The end result of the ACE Survey is a score between 0 and 10.

The average age of participants in the original study was 59 so study subjects were responding to questions about their childhoods decades ago. Fully two-thirds of the study participants had at least 1 ACE: 26% had 1 ACE; 16% had 2 ACEs; 10% had 3 ACEs; just over 13% had 4 or more ACEs. Simply put, the research found tremendous, lifelong impacts on health and quality of life with extremely strong, highly significant associations with physical health, mental health, and risky behaviors, including: heart disease, cancer, stroke, obesity, diabetes, broken bones, depression, suicide attempts, smoking, and substance abuse. Higher ACE scores were also correlated with missed work/reduced productivity and even early mortality. Since the original seminal research, there have been over 50 additional studies published on ACEs.2 

Supporting healthy environments for children at home, in school and in the community is critical to the health outcomes for children across their lifespan. Every year, nearly one million children are victims of abuse or neglect in the United States.3  The most important reason to prevent child abuse and neglect is to improve the lives and hopes of children and families. But the benefits to society extend well beyond better lives for children. The CDC has estimated that the costs associated with child abuse and neglect (investigations, interventions and treatment, foster care, chronic health problems, lost productivity) exceed $104 billion annually in the United States.4 The high costs are felt not just in families or by government programs, but in businesses, too. The consequences of child abuse have a huge impact on the business community in terms of chronic health issues, missed work, lower productivity, etc. Prevention efforts are crucial if we are to decrease the incidence of childhood trauma and abuse and improve the health of our communities.

These are some of the reasons why Prevent Child Abuse Vermont promotes safe, stable, and nurturing relationships and environments for children. The future of our nation depends on the well-being of our children. The effects of early adversity can be ameliorated and, even better, abuse and neglect can be prevented when parents and communities have empathy for children's needs, understand child development, and have informed, supportive networks in place.


  1. Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the adverse childhood experiences (ACE) study. Am J Prev Med. 1998; 14: 245–258.