#ACEs (Adverse Childhood Experiences)
A CDC study identifying how childhood trauma impacts lifelong health and behavior.
The ACEs Study (1995-1997)
Kaiser Permanente + CDC surveyed 17,000+ adults about:
- Abuse (physical, emotional, sexual)
- Neglect (physical, emotional)
- Household dysfunction (domestic violence, substance abuse, mental illness, incarceration, divorce)
Scoring
Each category counts as 1 point (max score: 10)
- ACE score of 4+ = dramatically increased risk for:
- Chronic disease (heart disease, diabetes, cancer)
- Mental illness (depression, suicide attempts)
- Substance abuse
- Relationship problems
- Early death
Why It Matters
The study revealed:
- Trauma affects brain development
- Toxic stress impacts immune system
- ACEs are dose-dependent (more trauma = worse outcomes)
- ACEs are common (67% have at least 1)
Protective Factors
Having high ACEs doesn’t doom you:
- Supportive relationships
- Therapy
- Stable adult environment
- Community connection
- Resilience-building
Criticisms
- Doesn’t include racism, poverty, community violence
- Can be used to pathologize survivors
- Scoring oversimplifies complex experiences
Expanded ACEs
Some versions now include:
- Bullying
- Racism/discrimination
- Living in unsafe neighborhood
- Witnessing violence
Resources
- ACEs quiz: https://acestoohigh.com/got-your-ace-score
- The Deepest Well (Nadine Burke Harris, 2018)
- https://www.cdc.gov/violenceprevention/aces