What is the ACE Study and Why Is It Still Relevant?

What is the ACE Study?

The adverse childhood experiences (ACE) study was a study conducted at Kaiser Permanente from 1995 to 1997. It is one of the largest investigations of childhood abuse and neglect and household challenges and later-life health and well-being. This means they explored how traumatic childhood events may negatively affect those people as adults.

An adverse childhood experience was a way of “quantifying” exposure to trauma by conditions in the household prior to age of 18. For example, this may include exposure to physical abuse or an incarcerated household member. See the full list below:

These scores are added up for a result from 0-10. The higher the score, the more likely negative future health outcomes are.

Significant Findings

The study found adverse childhood experiences to be surprisingly common across all populations. Almost two-thirds of study participants reported at least one ACE, and more than one in five reported three or more ACEs. However, some populations are more vulnerable to experiencing ACEs because of the social and economic conditions in which they live in (the social determinants of health).

The ACE score is the total sum of the different categories of ACEs reported by participants. Study findings show a graded dose-response relationship between ACEs and negative health and well-being outcomes. In other words, as the number of ACEs increases, so does the risk for negative outcomes.

The study demonstrates the importance of gathering information early in the lives of children and their families and designing early intervention programs that target violence and neglect. The high prevalence of adverse experiences was significant as well.

Understanding why our health outcomes differ in varying environments can help us decrease these health inequities. This may involve abolishing the prison industrial complex to allow for healing of drug users and eliminate the number of incarcerated relatives, or ensuring that families have adequate supports in place to decrease stressors that may result in different types of abuse or neglect.

How Do We Lower ACE Scores?

• Strengthen economic supports to families

• Ensure affordable housing and livable wages

• Improve accessibility of mental health supports

• Defund the police with reparations to those disproportionately harmed

• End the war on drugs and fund evidence-informed harm reduction strategies

• Improve accessibility to abortions, a human right

• Fund education

How Do We Lessen the Harm Adverse Experiences Cause?

• Increase accessibility to mental health supports to help those with adverse childhood experiences cope better, but to also end the cycle associated with intergenerational trauma

• Reform our healthcare system

• End the war on drugs - drug policy reform, invest in harm reduction, and reparations

• Systems change to address health inequities that populations face

• Defund and eventually abolish the police and replace with system that does not disproportionately harm marginalized populations

References

Centers for Disease Control and Prevention. (2021). About the CDC-Kaiser ACE Study. Retrieved from https://www.cdc.gov/violenceprevention/aces/about.html#:~:text=The%20CDC%2DKaiser%20Permanente%20adverse,two%20waves%20of%20data%20collection.