Yep, to Felitti & Anda's surprise, the ACE Study found that no one ACE was more damaging than any other, population-wise. And, more important, it was the increasing number of types of ACEs....the ACE score....that resulted in the increasing risk for chronic disease, mental illness, violence, being a victim of violence, prescription drug use, and a host of other consequences. So...having one ACE is less risky than having four. And if you have four, it doesn't matter which four.
Of course, since the ACE Study measured the original 10 ACEs, other surveys have added racism, bullying, witnessing violence outside the home, living in an unsafe neighborhood, and involvement with the foster care system as other ACEs.
And then there's the added consideration of resilience factors -- early data suggests that a high ACE score can be ameliorated by a high resilience score.
But the message I take from all of this is: let's change our systems so that we're responding and assisting earlier, at the first warning signs, until waiting for serious damage to be done to children and adults! And let's make sure the organizations, systems and communities that we work, play, pray and live in aren't toxic, but resilient and self-healing.