For children, stressful or traumatic events – like the sudden death of a parent, a family member’s untreated mental health condition or witnessing violence – can have immediate effects on their physical and mental health. They can also have a lifelong impact.
Traumatic or stressful experiences are so closely linked with a child’s health and wellbeing that they’ve been given an acronym – ACES, for adverse childhood experiences – and are studied by researchers. Which is why experts know that if a child has experienced trauma or severe stress, they are more likely to develop chronic health conditions. The U.S. Centers for Disease Control and Prevention estimates up to 1.9 million cases of heart disease and 21 million cases of depression could have been potentially avoided by preventing adverse childhood experiences.
Childhood stress and trauma affects more of us than we realize: about 61% of U.S. adults reported experiencing at least one adverse childhood experience – violence, abuse, neglect or instability at home, according to the CDC.
For adults, it’s important to understand how childhood experiences ultimately affect long-term health – and how interventions and prevention can make a difference.
What are ACES?
ACES, or adverse childhood experiences, are events or circumstances that may be traumatic to children under the age of 18. They can include:
- Experiencing violence, abuse or neglect
- Witnessing violence at home or in the community
- Having a family member attempt or die by suicide
ACES can also include different parts of a child’s environment that may affect how safe they feel and how stable and predictable their day-to-day lives are. Households that experience substance use issues, untreated mental health conditions or lack of consistent adult presence can present a chaotic environment for children.
ACES are often connected to social determinants of health: factors outside of your control that ultimately determine health and well-being. Housing and neighborhoods, household income, food insecurity, access to health care and education are some of the main factors.
What are the consequences of ACES?
For children that have experienced ACES – like a chaotic home life or living through a traumatic event – they are more likely to undergo toxic stress, according to the CDC. In children, toxic stress is the body’s response to lasting, negative stress from trauma, abuse or neglect. Without help from a caregiver, children can’t turn off their internal stress response – which can harm their body and brain in lifelong ways.
"Toxic stress from childhood can harm the endocrine, immune, and nervous systems,” said Dr. Angela Seabright, care management physician at Blue Cross Blue Shield of Michigan. “Changes to the brain from toxic stress can lead to difficulty regulating emotions and behavior.”
Coping with toxic stress may lead to behaviors that can put children’s health and wellbeing on the line and may affect a child’s ability to form a healthy relationship as an adult. There are increased rates of teen pregnancy, sexually transmitted infections and risk of injury.
Experiencing chronic stress and trauma as a child doesn’t just connect to riskier behavior and unhealthy coping mechanisms. It can seriously affect a child’s body and mind as they grow and develop; and affect their long-term health as it puts them more at risk for chronic diseases, including cancer, diabetes and heart disease.
There is a growing body of research on the possible connection between ACES and the development of asthma in children. In some studies, behavior problems and family conflicts occurred directly before children developed asthma. And strong emotions and stress are well-known triggers of asthma, according to the Asthma and Allergy Foundation of America. While rates of asthma attacks are on the decline in the U.S., asthma is a leading chronic disease in children – and it has a disparate impact: non-Hispanic Black children are more than two times more likely to have asthma compared to non-Hispanic white children.
A recent Vital Signs study from the CDC found that preventing ACEs could potentially result in a:
- 44% reduction in depression
- 26% reduction in COPD
- 24% reduction in heavy drinking
- Almost 13% reduction in coronary heart disease
“Nurturing relationships with caring adults who are positive role models can prevent ACEs and help children reach their full potential,” Dr. Seabright said.
Protecting children takes a community approach rooted in partnerships to ensure safe, stable home environments for life-long health.