(Source: Adverse Childhood Experiences infographic, Centre for Public Health, Liverpool John Moores University)
In England, there is growing awareness of the importance of early life experiences in setting children’s paths in life and increasing policy focus on early interventions. Yet little is actually known about how many people are affected by adverse experiences in childhood or how they impact on health-related behaviors. We wanted to develop this knowledge and at the same time estimate what impact preventing these experiences might have on the prevalence of health-harming behaviors nationally.
To do this, we conducted a nationally representative household survey of adults across England. We surveyed around 4,000 18-69 year olds using a questionnaire that included a range of questions on past and current health-related behaviors and a short ACE tool developed by the US Centers for Disease Control and Prevention. This measures nine adverse childhood experiences occurring before the age of 18: physical abuse, sexual abuse, verbal abuse, exposure to domestic violence, parental separation, and living with a household member who has alcohol problems, uses drugs, is mentally ill or is incarcerated.
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The really novel part of our study was its estimation of how many people could have been prevented from engaging in health-harming behaviors if they had not had these experiences.
By quantifying the relationship between adverse childhood experiences and the development of health-harming behaviors we estimated the reduction in prevalence of each behavior that would be seen in the absence of these experiences and the numbers of individuals that this equated to across England.
For current levels of smoking, for example, we estimated that with no adverse experiences national prevalence would drop from 22.7% to 18.9%; a 16.5% reduction. In terms of numbers, this would equate to 1.3 million fewer adult smokers across England. For violence, we estimated that prevalence of past-year victimization would drop from 5.8% to 2.9%, a reduction of 50.6% and equivalent to just over a million victims of violence a year.
Adverse Childhood Experiences: The long-term impact by Dr. Karen Hughes, Centre for Public Health, Liverpool John Moores University
Full study in BMC Medicine: National household survey of adverse childhood experiences and their relationship with resilience to health-harming behaviors in England
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