Adverse childhood experiences and adult health outcomese

Adverse childhood experiences and adult health outcomes

What is going on?

According, to the CDC Adverse Childhood Experiences (ACEs) have been linked to risky health behaviors, chronic health conditions, low life potential, and early death and as the number of ACEs increases, so does the risk for these outcomes (CDC, 2016) that make it an important public health issue.


Childhood experiences, both positive and negative, tremendously affect future viciousness abuse and execution, and deep rooted wellbeing and opportunity. Adverse childhood experiences are associated with the development of substance use disorders. With opioid use disorder, a growing concern in the United States (Stein, D. Micheal et al. 2017). Additionally to another study, exposure to adverse childhood experiences (ACEs) is a significant risk factor for physical and mental illnesses later in life (Zechen Ma et al. 2017).

In the literature Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults, came to a conclusion that there is a strong graded relationship between the breadth of exposure to abuse or household dysfunction during childhood and multiple risk factors for several of the leading causes of death in adults (Felitti, Vincent J et al. 1998). This is important because we have a number of adults dying or having different health outcomes from being exposed to ACEs, with an already lesser life expectancy compared to other developed countries.

So What?

Child abuse and neglect affect children’s health now and later, and costs to our country are significant.

1 in 4 children suffer abuse. An estimated 676,000 children were confirmed by child protective services as being victims of abuse and neglect in 2016 (U.S. Department of Health and Human Services. 2016).

At least one in four children have experienced child neglect or abuse (including physical, emotional, and sexual) at some point in their lives, and one in seven children experienced abuse or neglect in the last year (Finkelhor D et al. 2015).

In one long-term study, as many as 80% of young adults who had been abused met the diagnostic criteria for at least one psychiatric disorder at age 21 (Silverman AB, Reinherz HZ, & Giaconia RM. 1996).

The estimated average lifetime cost per death is $1,272,900, including medical costs and productivity losses (Fang X, Brown DS, Florence CS, Mercy JA. 2012).

Research suggests the benefits of effective prevention likely outweigh the costs of child abuse and neglect.

What to do about it?

Jessamine County Health Department recently developed a coalition with the community and one of the issues they are looking at improving is ACEs in the community. Below are ideas that JCHD is planning to out in place to tackle ACEs.

  • Early childhood home visitation and parenting skill and family relationship approaches through parenting with an already existing program at the health department HANDS and WIC. Those two programs interact with parents and families with young children; they can enhance parenting skills to promote healthy child development.
  • Changing social norms to support parents and positive parenting over public engagement, educational campaigns and reduced coral punishments using law. This can be achieved by working with the schools, legislatives, safety and the health department.


Centers for Disease Control and Prevention, Kaiser Permanente. The ACE Assignment Survey Data

[Unpublished Data]. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2016.

CDC. Adverse Childhood Experiences (ACEs). 2016

Fang X, Brown DS, Florence CS, Mercy JA. The economic burden of child maltreatment in the United States and implications for prevention.Child Abuse Negl.2012;36(2), 156–165.

Felitti, Vincent J et al. Relationship of Childhood Abuse and Household Dysfunction to Many of

the Leading Causes of Death in Adults. American Journal of Preventive Medicine , Volume 14 , Issue 4 , 245 – 258

Finkelhor D, Turner HA, Shattuck A, Hamby SL. Prevalence of childhood exposure to violence, crime, and abuse: Results from the National Survey of Children’s Exposure to Violence.JAMA Pediatr.2015;169(8), 746-754.

Ma, Z., Bayley, M. T., Perrier, L., Dhir, P., Dépatie, L., Comper, P., Ruttan, L., … Munce, S. E.

(2017). The association between adverse childhood experiences and traumatic brain injury/concussion in adulthood: A scoping review protocol.BMJ open,7(10), e018425. doi:10.1136/bmjopen-2017-018425

Silverman AB, Reinherz HZ, Giaconia RM. The long-term sequelae of child and adolescent abuse: a longitudinal community study.Child Abuse Negl.1996;20(8):709–723.

Stein, M. D., Conti, M. T., Kenney, S., Anderson, B. J., Flori, J. N., Risi, M. M., & Bailey, G. L.

(2017). Adverse childhood experience effects on opioid use initiation, injection drug use, and overdose among persons with opioid use disorder.Drug and alcohol dependence,179, 325-329.

U.S. Department of Health and Human Services. Administration on Children, Youth and Families,

Children’s Bureau. (2018).Child maltreatment 2016. [online] Available from:

Program: __Winnie Atim____ Logic Model

Situation: Adverse childhood experiences and adult health outcomes



Outcomes -- Impact




Staff (labor)

JCHD staff, police staff, legislative, community members, School administration.

Time that works for everyone


Materials needed

Workshops in schools, communities

One on one home visits using HANDS & WIC programs

Train teachers on how to spot ACEs in child

Counseling for children and parents that can be reached


Using media to change social norms





Health department



Skills for teachers and community to spot ACEs

Awareness of students affected by ACEs

Learning what the causes and triggers of ACEs are.

Changing opinions of some students labeled.

Put what they learnt in practice

Adopted in classroom, community.

Polices enforced to stop abuse from parents and adults

Actions are being taken to help those who need it

Reduce/ Eliminate health problems related to ACEs

Create an environment without ACEs

Condense the cost per death related to ACEs


External Factors

We have funding for classes

All partners are willing to hold up their end.



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