SARA HEATH, XTELLIGENT HEALTHCARE MEDIA
As part of their pursuit of understanding and addressing social determinants of health (SDOH), medical professionals should also consider adverse childhood experiences (ACEs).
According to data from the National Survey of Children’s Health, 34.8 million children across the US are impacted by ACEs, known as traumatic events experienced during childhood.
Figures from the Centers for Disease Control and Prevention show that 61 percent of adults can recount at least one ACE from their childhood, and about one in six were able to report they’d experienced four or more types of ACEs.
And considering the downstream impacts adverse childhood experiences can have on adult health, these issues are costly. CDC said the economic and social cost of ACEs rounds out to hundreds of billions of dollars annually. The agency said reducing ACEs in North America by 10 percent could result in $56 billion in cost savings each year.
Below, PatientEngagementHIT defines ACEs, outlines the consequences of adverse childhood experiences, and reviews the current state of ACE mitigation strategies.
WHAT ARE ADVERSE CHILDHOOD EVENTS (ACES)
According to the CDC, ACEs are “potentially traumatic events that occur in childhood (0-17 years).”
ACEs often relate to experiences of neglect, abuse, and family dysfunction, but according to Carmela Sosa, MD, the medical director of the Guilds Center for Community Health with Valley Children’s Hospital, ACEs can also be more expansive. Serious issues with common social determinants of health, like housing insecurity or food insecurity, can also make for potentially traumatic events.
“ACEs are just one piece of the complex interplay that makes up SDOH, and all are beyond a child’s control,” Sosa wrote in a resource for Central California Pediatrics.
EXAMPLES OF ACES
There is no exhaustive list of adverse childhood experiences, according to the CDC. However, some common adverse childhood experiences may include:
- Experiences of abuse, violence, or neglect
- Witnessing community or family violence
- Having a family member attempt or die by suicide
- Growing up in a household with substance use or mental health problems
- Family instability, like parental separation or household members being incarcerated
It’s important to note that many ACEs can compound. A child may experience abuse while also experiencing homelessness. Just like other social determinants of health, ACEs are complex and require serious study.
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