Adverse Childhood Experiences 
(ACEs)

What are ACEs?

Traumatic childhood events such as abuse, neglect, and witnessing experiences like crime, parental conflict, mental illness, and substance misuse can result in long-term negative effects on physical, social, emotional, and cognitive development. Often referred to as adverse childhood experiences (ACEs), these types of events create dangerous levels of stress that can derail healthy brain development, and increase risk for smoking, alcoholism, depression, heart disease, and dozens of other illnesses and unhealthy behaviors throughout life. The three categories of ACEs include: abuse, neglect, and household dysfunction.

ACEs affect children and families across all communities. They even have consequences that affect entire families, communities, and our whole society. As Chief Public Health Strategists we are using a transformative approach to foster collaboration across child health, public health, and community-based agencies to address the root causes of toxic stress and childhood adversity and to build community resilience.

How Prevalent are ACEs?

The ACE Study is an ongoing collaboration between the Centers for Disease Control and Prevention (CDC) and Kaiser Permanente. It analyzes the relationship between childhood trauma and social and health consequences later in life. The ACE Study used a simple scoring method to determine the extent of each study participant's exposure to childhood trauma. Exposure to one category (not incident) of ACE, qualifies as one point. When the points are added up, the ACE Score is achieved. An ACE Score of 0 (zero) would mean that the person reported no exposure. Of the 17,000 ACE study participants, the following data was collected:

What Impact do ACEs Have?

ACEs activate the stress response system, disrupting brain and organ development and weakening the defense system against diseases. As the number of ACEs increases, so does the risk for negative health outcomes. The data below is just an example of how ACEs impact health and wellbeing. 

ACEs Solution Framework
Essentials for Childhood: Creating Safe, Stable, Nurturing Relationships and Environments

Safety: The extent to which a child is free from fear and secure from physical or psychological harm within their social and physical environment.

Stability: The degree of predictability and consistency in a child’s social, emotional, and physical environment.

Nurturing: The extent to which children’s physical, emotional, and developmental needs are sensitively and consistently met.

The Essentials for Childhood Framework is intended for communities committed to both promoting the positive development of children and families, and preventing child abuse and neglect. The framework has four goal areas and suggests strategies based on the best available evidence to achieve each goal. The four goal areas include:

Goal 1: Raise awareness and commitment to promote safe, stable, nurturing relationships and environments and prevent child abuse and neglect.

Goal 2: Use data to inform actions - Use partnerships to help identify, gather and synthesize relevant data.

Goal 3: Create the context for healthy children and families through norms change and programs.

Goal 4: Create the context for healthy children and families through policies.

Community Supports

We all have a role in preventing ACEs and building resiliency. We must increase public understanding of ACEs and their impact on health and well-being.  As more is learned about the causes and effects of ACEs, collaborative approaches are emerging to promote safe, stable, and nurturing relationships and environments.  

We must enhance the capacity of families and providers to prevent and respond to ACEs. We must commit to advancing effective services and interventions by creating trauma-informed, developmentally and culturally appropriate programs that improve the standard of care. Through more effective prevention of ACEs, as well as better intervention with those who have already had adverse experiences, Greater Nashua will foster a community dedicated to reducing the burden ACEs have on children, families, and society as a whole. 

By recognizing shared goals, building on areas of strength, sharing data, and aligning comprehensive efforts, the Greater Nashua Public Health Advisory Council will create a greater impact, stronger partnerships, more resources, better evaluation, and increased sustainability.

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