ACEs: Why They Matter

Adverse Childhood Experiences

ACEs cut across all economic, racial and educational lines and reach all zip codes.

1998 Kaiser Permanente-CDC study showed that when children under 18 experience stressful or traumatic events such as violence at home, neglect, abuse, or having a parent with mental illness or substance dependence, their brains and bodies can change. The study correlated 10 specific ACEs to almost every major health, mental health, economic and social outcome in people with 4 or more.

Graphic content courtesy of Robert Wood Johnson Foundation.


The Consequences of ACEs

The findings of the ACEs study were stunning and showed the connection between the impact of ACEs on the brain and body, and the ability to function as adults in life and in the workplace. ACEs, particularly when there is more than one, lead to much higher rates of:

  • ACEs are the leading determinant of public health spending in the US.
  • ACEs cause chronic disease, such as cancer and heart disease, as well as mental illness.
  • People with lots of ACEs are more likely to be violent, and a victim of violence.
  • ACEs are common; 64% of adults have at least one.
  • ACEs don’t occur alone; if you have one, there’s an 87% chance that you have two or more.

What ACEs Mean

The study was used to create an ACEs “score” to help describe how having more than one adverse experience increases the likelihood of negative physical and mental health outcomes. For each ACE a person experienced under the age of 18, they would have 1 point, with a possible total of 10. Each ACE counts as one, no matter how many times it occurs.

High ACE scores are responsible for a big chunk of workplace absenteeism, and for costs in health care, emergency response, mental health and criminal justice.

People who experienced 4 or more ACEs as a child are:
At significantly greater risk for 7 out of 10 leading adult causes of death, including heart disease, stroke, cancer, COPD, diabetes, Alzheimers and suicide.
Twice as likely to be smokers and seven times more likely to be alcoholic.
Have an increased risk of emphysema or chronic bronchitis by nearly 400 percent
12 times more likely to commit suicide

Lifetime Impact

Adversity experienced as a child can impact a person throughout a lifetime, if not buffered or healed, resulting in ever-expanding negative outcomes. Considering the solutions requires looking at the impact on the person across the lifespan.

The good news is ACEs can be addressed at any point during a person’s life. Visit Resilience for more information.



You Are Not Your ACE Score

ACEs is just one way to talk about the impact of adversity on the developing brain, and a way to highlight the importance of early childhood, and developing an understanding of adult behavior.

ACEs changes the conversation from what’s wrong with you to what happened to you.

Resilient Napa uses the score as a way to raise awareness of the impact of adversity on children, and the need for protective factors, such as safe, stable, nurturing relationships. It is not an assessment or diagnostic tool. It is a tool to help you better understand  where people might be coming from when they act a certain way, and at a higher level, to think about what changes we need to make in our community and our systems so we can more effectively help people flourish.