Building awareness of ACEs while empowering people and communities

Adverse Childhood Experiences, or ACEs, are stressful, potentially traumatic experiences we face before age 18. A landmark CDC-Kaiser Permanente study in the 1990s assessed ten types of ACEs, including physical, emotional, and sexual abuse, physical and emotional neglect, caregiver divorce or separation, growing up in a household with mental illness, problematic substance use, domestic violence, or someone who is incarcerated. ACEs are common; two out of three of us have at least one, and one in six of us have experienced four or more.

Without protective factors and adequate support, ACEs can lead to prolonged activation of the body’s stress response, a condition known as the toxic stress response. Toxic stress can alter developing body systems and brain architecture, affecting both mental and physical health throughout the lifetime – even making changes to our DNA that can impact generations.

ACEs have a dose response relationship with more than 40 associated health conditions, including heart disease, stroke, asthma, cancer, depression, anxiety, problematic substance use, and suicide. ACEs can impact early learning and development, educational attainment, career performance and trajectory, relationships, and lifespan.

Additional studies have found that some people are likely to experience significantly more ACEs than others, including Black, Hispanic or Latino, or multiracial people, people with less than a high school education, people with low incomes, people who are unemployed or unable to work, and LGBTQ+ people. Science has also proven that adversities like racism, discrimination, poverty, and community violence can have similar impacts as ACEs.

Many people – including caregivers, health professionals, and educators – don’t know about the impacts of ACEs, other childhood adversity, and toxic stress. This leads to significant illness, intergenerational trauma and suffering, and enormous expense – much of which could be averted through awareness, education, and action.

Prevention and healing are possible, and we can break cycles and create individual, community, and systems-level change.