The ACE Study: The Discovery That Changed Public Health

What is the ACE Study?

The Adverse Childhood Experiences (ACE) Study, conducted by Dr. Vincent Felitti and Dr. Robert Anda at Kaiser Permanente and the CDC (1995-1997), surveyed over 17,000 adults about childhood adversity. The findings shocked the medical community:

Childhood trauma strongly predicts adult disease, mental illness, addiction, and early death.

This wasn't just correlation—it was dose-response. The more childhood adversity you experienced, the higher your risk for virtually every major cause of death in America.

The 10 Original ACE Categories

Abuse (3 types)

1. Emotional abuse
2. Physical abuse
3. Sexual abuse

Neglect (2 types)

4. Emotional neglect
5. Physical neglect

Household Dysfunction (5 types)

6. Mother treated violently
7. Substance abuse in household
8. Mental illness in household
9. Parental separation/divorce
10. Incarcerated household member

Your ACE score = the number of categories you experienced before age 18.

The Health Impacts: ACE Score Breakdown

ACE Score 0

Baseline health risk.

ACE Score 1

Slightly elevated risk for some conditions.

ACE Score 2-3

Moderate risk increase for:

• Depression (2.5x higher)
• Chronic lung disease (2x higher)
• Liver disease (2x higher)

ACE Score 4+

• Heart disease: 2x risk
• Diabetes: 1.6x risk
• Suicide attempts: 12x risk
• Depression: 4.6x risk
• Alcoholism: 7x risk
• COPD: 3.9x risk
• IV drug use: 10x risk

ACE Score 6+

• Life expectancy reduced by 20 years on average
• 46x higher risk of IV drug use
• 30x higher risk of suicide attempts

Why Does Childhood Trauma Cause Adult Disease?

1. Toxic Stress (Biological Mechanism)

Chronic childhood stress dysregulates:

• HPA axis (cortisol, stress hormones)
• Immune system (chronic inflammation)
• Cardiovascular system (high blood pressure, heart disease)
• Metabolic system (diabetes, obesity)

Dr. Nadine Burke Harris calls this "toxic stress"—stress so severe and prolonged it damages the developing brain and body.

2. Coping Behaviors (Behavioral Mechanism)

Trauma survivors often cope through:

• Smoking, drinking, drugs (numbing pain)
• Overeating (emotional regulation)
• High-risk behaviors (sensation-seeking to feel alive)

These behaviors provide short-term relief but cause long-term disease.

3. Interpersonal Patterns (Social Mechanism)

ACEs affect:

• Ability to form healthy relationships
• Trust and emotional regulation
• Parenting patterns (intergenerational trauma)

The Hope: ACEs Are Not Destiny

Key insight: ACE scores predict risk at population level, not individual destiny.

Many people with high ACE scores thrive through:

• Resilience factors: Supportive relationships, safe spaces, therapy
• Trauma-informed care: Therapists who understand ACEs
• Self-awareness: Understanding how your past affects your present
• Healing modalities: EMDR, Somatic Experiencing, attachment repair

Protective Factors

Dr. Bruce Perry's research shows protective factors that buffer ACE impacts:

1. At least one stable, caring adult in childhood
2. Safe, predictable environments
3. Opportunities for healing and growth
4. Access to mental health support
5. Connection to community/culture/spirituality

Our ACE Assessment

Our ACE Assessment includes:

• The original 10 ACE questions
• Expanded ACEs (bullying, community violence, discrimination)
• Protective factors assessment
• Resilience resources evaluation

After completing it, you receive:

• Your ACE score and interpretation
• Health risk information (with empathy, not fear)
• Trauma-informed healing recommendations
• Resilience-building strategies

Take the Next Step

Understanding your ACE score is the first step toward healing. Take our comprehensive ACE Assessment and receive personalized recommendations.

Calculate Your ACE Score →

---

References:

• Felitti, V. J. et al. (1998). Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults. American Journal of Preventive Medicine, 14(4), 245-258.
• Burke Harris, N. (2018). The Deepest Well: Healing the Long-Term Effects of Childhood Adversity. Houghton Mifflin Harcourt.