Official websites use. Share sensitive information only on official, secure websites. Email: wlarkin warrenlarkinassociates. It has been over 20 years since the publication of seminal research by Felitti et al , highlighting the powerful relationship between adverse childhood experiences ACEs and a wide range of health and wellbeing outcomes. Since the landmark ACE study was published, a compelling body of research has accumulated confirming the strong and proportionate relationship between experiences of childhood adversity and the manifestation of detrimental health and social outcomes later in life.
We have an evolving understanding of the neurodevelopmental links between adversity and poor mental and physical health outcomes. We have evidence that the negative effects of ACEs can be mitigated through psychosocial and resilience building interventions.
ACE enquiry is becoming more common in the US primary care system and in paediatric medicine, with emerging evidence of significant human and financial payoff.
In this editorial we hope to explore some of the enablers and barriers related to implementing ACE enquiry in a UK primary care context. The ACEs concept most often refers to a list of ten categories of abuse, neglect, and household dysfunction, experienced before the age of 18 years. These are: parental mental illness; parental substance misuse; parental alcoholism; living with a parent or adult who went to prison or youth offending institution; parental divorce or separation; being exposed to domestic abuse; experiencing emotional, sexual or physical abuse; and significant neglect.
For example, we know that poverty is positively correlated with many of the ACEs on this list, 6 and living in an area lacking social cohesion or having high levels of crime and violence can have a similarly negative impact on emotional wellbeing and health outcomes.
