“ACE’s are the single greatest unaddressed public health threat” these are the words from Dr. Nadine Burke Harris, the current Surgeon General of California. Dr. Burke Harris was quoted during a TED talk titled “How childhood trauma affects health across a lifetime.”
Well, what are ACEs?
ACE’s is an acronym for the term adverse childhood experiences. The term arrived following the ACE study done in 1998. The study was performed by Kaiser Permanente and the Center for Disease Control. The research was done to analyze the connection between chronic stress as a result of adverse experiences and their effect on long-term health. Participants in the study were given a questionnaire based on their childhood experiences. For every one of the adverse experiences they encountered during their childhood, they received one point. Examples of the adverse experiences measured are abuse & neglect, domestic violence, mentally ill parents’, and substance abuse.
From the study, there were two observable findings. One of them was that ACE’s were more common than expected. 67% of the participants recorded at least one adverse childhood experience. 13% of participants recorded to have experienced four or more adverse childhood experiences. The total tally of someone’s ACEs would determine their score. The hypothesis was that the higher the ACE score, the worst long term health complications would be. The results of the study showed a graded dose-response. The premise was valid; the higher the number of ACEs someone encountered resulted in them being at higher risk for chronic health complications in the future.
There was a time I had the chance to speak with a respiratory therapist. Having been an employee in health care for many years, he explained to me a scenario I would never forget. The situation he told was if you’re driving a car on the road and it has a flat tire, you can fix it. Say now, you drive on that same road, and the tires become flat once more. You can continue to fix the tires, but eventually, one should begin to wonder what is on that road that is causing the tires to go flat. That scenario he explained was an example of the current state of our healthcare system. The United States health care system sometimes provides temporary fixes to problems without looking at the underlying causes of those issues. This makeshift approach may be setting people up for reoccurring and chronic diseases.
A way the United States could help address ACEs and shift from temporary fixes is through primary prevention. According to the Child Welfare Information Gateway, primary prevention are attempts to avoid adverse health outcomes before they occur. For primary prevention to work, there needs to be a common ground between the general public, service providers, and policymakers. Primary prevention would include identifying which groups are most likely to be affected by ACEs. The groups at higher risk are the ones that are low-income and people from minority groups. After identifying the people at high risk, we must place the right resources around them to prevent the health outcomes that eventually may await them.
Health Ineqaulities 