Adverse Childhood Experiences (ACE) Study
The Relationship of Adverse Childhood Experiences to Adult Health:
Turning gold into lead –Vincent J. Felitti, MD of Kaiser Permanente & Robert Anda, MD at the Centers for Disease Control
The Adverse Childhood Experiences (ACE) Study is a major American research project that reveals a powerful relationship between our emotional experiences as children and our physical and mental health as adults.
The ACE Study was carried out by Vincent J. Felitti, MD of Kaiser Permanente Medical Care Program and Robert Anda, MD at the Centers for Disease Control. The following is a summary based on a report written by Dr. Felitti in 2002. 17,421 adults volunteered at Kaiser Permanente’s Department of Preventive Medicine in San Diego to take part in the ACE Study of the following eight categories of childhood abuse and household dysfunction:
- Recurrent physical abuse
- Recurrent severe emotional abuse
- Contact sexual abuse
- Growing up in a household where someone was in prison
- Where the mother was treated violently
- With an alcoholic or a drug user
- Where someone was chronically depressed, mentally ill, or suicidal
- Where at least one biological parent was lost to the patient during childhood - regardless of cause
An individual exposed to none of the above categories was given an ACE Score of 0; and an individual exposed to any four of the ACEs was given a Score of 4, etc.
The two most important findings are that these adverse childhood experiences:
- Are vastly more common than recognized or acknowledged and,
- Have a powerful relation to adult health a half-century later.
The Study explores how these adverse childhood experiences play out decades later in a doctor’s office. Several measures of adult health were reviewed including: smoking, depression, drug and alcohol use, obesity, sexually transmitted diseases, and several others. The Study outcomes reveal a strong correlation between an individual’s ACE Score and the likelihood of that individual having a physical or emotional disorder.
The following table reveals some of the ACE Study findings:
| SMOKING | Individuals with a higher ACE Score were more likely to be a current smoker. 6% of those studied having an ACE Score of 0 were found to be current smokers, but 15% of those with a score of 6 or more ACEs were identified as current smokers. |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) | An individual with an ACE Score of 4 is 260% more likely to have COPD than is a person with an ACE Score of 0. |
| HEPATITIS | There was a 240% increase in the prevalence of Hepatitis from patients with an ACE score of 0 to patients with a score or 4. |
| INTRAVENOUS DRUG USE | A male child with an ACE Score of 6 has a 4,600% increase in the likelihood of later becoming an IV drug user as compared to a male child with an ACE Score of 0. |
| DEPRESSION | An individual with an ACE Score of 4 or more was 460% more likely to be suffering from depression than an individual with an ACE Score of 0. |
| ATTEMPTED SUICIDE | There was a 1,200% increase in attempted suicide when comparing those with an ACE Score of 0 and those with a Score of 4. The prevalence of attempted suicide increases by 30-51 times. The ACE Study found that between 66% and 80% of all attempted suicides could be attributed to adverse childhood experiences. |
The ACE Study finds that adverse childhood experiences are common, destructive, and have an effect that often lasts for a lifetime. They are the most important determinant of the health and well-being of our nation. Unfortunately, these problems are painful to recognize and difficult to deal with. Most physicians would far rather deal with traditional organic disease because it is easier to do so, but that approach also leads to troubling treatment failures and the frustration of expensive diagnostic quandary where everything is ruled out but nothing is ruled in.
Click the PDF link below to view the ACES study in its entirety.
 The Adverse Childhood Experiences (ACE) Study |