The impact of adverse childhood events (ACEs) can be lasting and costly on patient health and medical outcomes.
How ACEs shape long-term health, and steps physicians can take to understand and address them.
Adverse childhood experiences happen before adulthood and can cause trauma and can make a child feel like their home isn't safe or stable. Some examples of ACEs include violence, neglect, abuse, and family mental health or substance use problems. [1]
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Personally experiencing violence, abuse, or neglect
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Witnessing violence in the home or community
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Having a family member attempt or die by suicide
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Instability caused by substance use problems, mental health, parental separation, and/or household members being incarcerated
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ACEs in the United States
- About 64% of adults report experiencing at least one type of ACE before the age of 18 [2]
- Potential Consequences
- Chronic health risks: heart disease and/or depression
- Behavioral health conditions: substance use disorders
- Social challenges: unemployment or relationship struggles
The Long-Term Costs of ACEs [3]
How Can a Physician Address ACEs
- The long-term health impact of ACEs is a priority for TMA’s Council and Public Health Committees.
- TMA recommends integrating screening of ACEs into practice to identify root causes rather than only treating symptoms.
- View an in-depth discussion by a TMA panel on "Adversity and Toxic Stress – How Adverse Childhood Experiences Affect People’s Health," featuring Angelo P. Giardino, MD, Leslie Secrest, MD, and Thomas Kim, MD: https://youtu.be/UhRpxPkIb50
- Educational Resources/Sources
Last Updated On
April 03, 2025
Originally Published On
September 13, 2017