ACEs
- J. Farley
- Sep 6, 2020
- 4 min read
Updated: Nov 14, 2020
I learned about the ACEs study when I entered my masters program last year. ACEs stands for Adverse Childhood Experiences and it looks at how certain childhood stressors impact a person's long term health outcomes. The categories it looks at are varying types of abuse and neglect, along with what's called "household dysfunction," things like substance abuse or mental illness in a parent, and/or divorce.
That last one stood out. To me, there is a significant difference between abuse and divorce. Approximately half of the households in the US are divorced, surely its impact on us as a culture isn't the same as abuse. But when I went looking for the numbers of people who say they've been abused (physically or emotionally) it's nearly 60%, and that data is from 10 years ago! We are looking at a very high % of the population who falls into these categories. The ACEs data suggests that these experiences contribute to increased risks of physical health disparities as we age in ways that you wouldn't necessarily associate with those experiences; heart disease, cancers, COPD, immune issues among others. The idea that abuse as a child can lead to any of these physical health issues decades later surprised me and opened my eyes to how trauma impacts people long term. The higher your ACEs score, the more likely you are to have these health problems (doubling, quadrupling, and sometimes increasing risk 10-fold).
You can answer the ACEs questions here and determine your own ACEs score. I feel like I had a pretty good childhood in many ways, and yet my ACEs score still puts me at increased risk for certain health conditions. I guess they aren't mutually exclusive, ACEs scores and feelings about your childhood.
More than 60% of the country has at least 1 ACE, which means 60% of the country is at higher risk for some of the leading causes of death. Knowing this, we have a window into how we can help reduce risk for millions of people. If more people were aware of how adverse childhood experiences impact a life, and how many of us have at least 1 ACE, we could potentially shift the conversation around how to address those higher risk factors, namely prevention and policy. The healthcare industry, at least in part, began to shift years ago toward covering wellness/preventative exams (at least my insurance did). I can only assume it's because they began to recognize how prevention costs them less money (and of course save lives).
If we began looking at adverse childhood experiences from a preventative standpoint we could significantly improve the health of our nation. Educating parents on what types of influences will negatively impact their kids decades from now and providing guidance on ways to improve parenting skills, coping skills, address substance use, and get the mental health support they need to address whatever adverse impacts they experienced as children (it tends to be a cycle after all) is one way we could begin to address this issue and have a significant positive effect on families and individual lives. Creating the awareness and educating parents to address their own mental health needs which will help their children long-term, could drive policy changes around preventative healthcare, types of treatments covered, and prioritize an integrative healthcare approach.
I work with college students at my clinical practice internship this year. When meeting with my clients, I am sometimes struck by what they have experienced already at such a young age (and from what we know from the ACEs study, college age is not young for trauma to occur). Thus far I haven't used the data from the ACEs study in a purposefully clinical way, however I can see how answering the ACEs questions for themselves, knowing their score, and then having a conversation around how those experiences can impact them down the road may lead to fruitful discussions. Providing that awareness, knowing their ACEs score, and the subsequent implications for their physical health could be a productive intervention. It could open the door to new conversations around coping strategies, and an interest in creating long term health in their lives that may not have been on their radar yet. We wouldn't even have to talk directly about the individual adversities they've experienced if they weren't comfortable, we could keep it about the score and it's implications, though it may also create a drive for them to talk about the actual circumstances if they weren't already.
Helping them see the links between what has happened to them, and how those circumstances could show up later in their lives as chronic illness may help to create an environment where they are willing to actively address those issues. Knowing these experiences have long term effects on a life (and in unexpected ways) may be the thing that motivates them to really dig in and work on developing resiliency through improved coping skills along with healthier habits that they can build on little by little as they launch into the world.
*********
I've seen this video several times now and it never ceases to amaze me.
Comments