Adverse Childhood Experiences (ACEs)

And now, a random story about a landmark study on childhood trauma (lifted from Wikipedia) that fortunately doesn’t have any bearing on my life or the lives of anyone I know [sarcastic emoji].

In the 1980s, Vincent Felitti, head of Kaiser Permanente’s Department of Preventive Medicine in San Diego, conducted interviews with people who had left Kaiser’s obesity program, and discovered that a majority of the 286 people he interviewed had experienced childhood sexual abuse.


Felitti, with Robert Anda from the Centers for Disease Control and Prevention (CDC), went on to survey childhood trauma experiences of over 17,000 Kaiser Permanente patient volunteers. About half were female; 74.8% were white; 75.2% had attended college; all had jobs and good health care.

  • Physical abuse
  • Sexual abuse
  • Emotional abuse
  • Physical or emotional neglect
  • Exposure to domestic violence
  • Household substance abuse
  • Household mental illness
  • Parental separation or divorce
  • Incarcerated household member 

As researchers followed participants over time, they discovered that a person's exposure to the adverse childhood experiences (ACEs) above had a strong, graded relationship to numerous health, social, and behavioral problems, including smoking, alcohol and drug abuse, promiscuity, and severe obesity, and were correlated with illnesses including depression, heart disease, cancer and chronic lung disease.

Compared to an ACE score of zero (none of the experiences listed), having four different types of adverse childhood experiences was associated with a 700% increase in alcoholism, twice as much risk of being diagnosed with cancer, and a four-fold increase in emphysema. An ACE score above six was associated with a 30-fold (3000%) increase in attempted suicide.

What is encouraging about this study—and the decades of research that have followed it—is that it gives all of us words and reasons for why we do some of  the things we do, tools to turn those problems around, and grace for other people who live complicated lives.

Images from summer camps in Pennsylvania and New York.