By Brittany T. Smith, BS. Brittany is a Ph.D. student at the WVU School of Public Health in the Department of Social and Behavioral Sciences. Her primary research interest is in adverse childhood experiences and children who experience parental substance use. The research work she has done has been presented at state, national, and international conferences.
For many years health has been considered to be completely reliant on someone’s genetics, biology, or choices. Physical health problems being seen as a consequence of an injury, germ, or irregular organ function and mental health problems are the results of poor choices or chemical imbalances. However, research has begun to show that there is more to health and well-being. Experiences are behind the body’s vulnerability and protection from many physical and mental illnesses, especially childhood experiences. What happens during one’s childhood has a tremendous impact on the way their body and mind develop, with both adverse and positive childhood experiences playing their own roles.
What are adverse childhood experiences?
Adverse childhood experiences (ACES) are potentially traumatic events that occur before the age of 18. These experiences include but are not limited to:
- Physical Abuse
- Emotional Abuse
- Sexual Abuse
- Physical Neglect
- Emotional Neglect
- Parental Mental Illness
- Parental Substance Use
- Incarcerated Household Member
- Parental Divorce/Separation
- Domestic Violence
A landmark research study conducted in 1996 was able to show that experiencing these events was associated with a greater risk for various negative health outcomes. Results from the study found that when compared to those who had experienced zero ACEs those who experienced four or more ACE were: 1
- 2.2 x as likely to have been diagnosed with a heart disease
- 2.4 x as likely to have had a stroke
- 3.9x likely to have chronic bronchitis or emphysema
- 10.3 x as likely to have ever injected drugs
- 12.2 x as likely to have attempted suicide
More recent studies have also found that experiencing poverty, racism, and community violence are also ACEs.2 These experiences are believed to increase the risk for disease and because they often produce a long-term stress response. The body is then flooded with stress hormones for extended periods of time resulting in changes in hormone production and physical changes in the brain.3
What are positive childhood experiences?
Positive childhood experiences (PCE) are experiences that make a child feel safe and supported and promote resilience. The following are considered PCEs:
- Ability to talk with family about feelings
- Feeling the family supported them through hard times
- Enjoyed community traditions
- Felt they belonged in high school
- Felt supported by friends
- Had two non-parental adults who took interest in them
- Felt safe and protected by an adult in their household
A recent study conducted at John Hopkins found that experiencing many PCE was linked with better adult mental health. Even those who had experienced many ACEs but also had many PCE had better mental health when compared to those who did not experience many PCEs. 4
The Importance of Both
Evidence shows that what happens during one’s childhood has a lasting impact on their health for the remainder of their life. ACEs are more common than many believe and should be considered serious risk factors for many diseases. These experiences are often preventable! However, hope is not lost if a child has experienced many ACEs. Supporting children and showing them that they are safe by promoting PCEs can reduce the negative impact ACEs have on health.
1. Felitti VJ, Anda RF, Nordenberg D, et al. Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine. 1998;14(4):245-258.
2. Cronholm PF, Forke CM, Wade R, et al. Adverse Childhood Experiences: Expanding the Concept of Adversity. American Journal of Preventive Medicine. 2015;49(3):354-361.
3. Shonkoff JP, Garner AS, Siegel BS, et al. The lifelong effects of early childhood adversity and toxic stress. Pediatrics. 2012;129(1):e232-e246.
4. Bethell C, Jones J, Gombojav N, Linkenbach J, Sege R. Positive Childhood Experiences and Adult Mental and Relational Health in a Statewide Sample: Associations Across Adverse Childhood Experiences Levels. JAMA Pediatrics. 2019;173(11):e193007-e193007.