What is ACE?

Working as a physician in our nations’s capital was an eye-opener for me. In the clinic and the medical recovery facility for the homeless where I worked, I saw patients with so many problems that it was hard to keep track of them all. Like Sra. Guiterrez, a middle-aged lady who cleaned houses. She had high blood pressure, metabolic syndrome, high cholesterol, severe liver disease, chronic shoulder and arm pain, and then she got cancer. Or, Joe. He used to have a decent job in construction. But then he had an accident and couldn’t work. He lost his apartment, became homeless, started drinking and smoking more— then all his problems flared. Chronic bronchitis, peripheral vascular disease, serious heart disease, psoriasis and depression. And, soon thereafter, cancer. Why so many diseases? Lifestyle choices, stress, and poverty? Yes, these were big factors. But there was something else, something big, which I only came to understand later. Let me share with you what I have learned about Adverse Childhood Events or ACEs.

It all started in California 1985 in a Kaiser Permanente adult obesity clinic.  Dr. Vincent Fellitti wondered why more than half of his patients dropped out of the clinic, even though they had been losing weight. He kept asking more questions and eventually found out that many of these dropouts had a history of  childhood sexual abuse. To investigate this further, Dr. Felliti collaborated with Dr. Robert Anda of the Centers for Disease Control (CDC)  on a research project that became the Adverse Childhood Events or ACE study. The study of 17,337 adult patients was designed to investigate the role of childhood neglect and abuse (physical, emotional, and sexual) on later health. They developed the ACE test and a scoring system for this purpose. The results showed that childhood abuse, neglect, and trauma are common and that they directly correlate with negative health and wellbeing in adults. The higher the ACE score, the greater the risk of negative outcomes of all types: worse physical and mental health, addictions, accident rates, longevity…and, yes, obesity. High ACE scores also correlate with less healthy decision making, more risky behaviors, and epigenetic changes, which can even be passed to the next generation. Upon learning all this, I just shook my head and looked down with great sadness, remembering my Washington, D.C., patients and realizing how many strikes they had against them from day one.

What can I do about a high ACE score?

When you first learn about ACEs, it can be depressing. Maybe you realize you have a high score and think you are doomed. Or, maybe you recognize that the home in which you raised your own children was unhealthy or stressful because of conflict, death, or divorce. Does this mean you consigned your own children to an unhealthy future? Perhaps you feel distressed just knowing how common ACEs are in our society? Instead of this negative thinking, consider these 4 positive steps.

  1. If you are worried about your own high ACE score and what it means for your future, know that the changes in you do not have to be permanent. Much is being learned and written on how to reverse the effects of ACEs. A Childhood Disrupted and all the work being done by that book’s author, Donna Jackson Nakazawa, is one example. Many of the practices I suggest in my blogs will also help you. To give you a better idea what I’m talking about, here is a bare bones list of healing activities: giving and receiving love, finding meaning and purpose to your life, enjoying quiet and nature, participating in a meaningful community, exercise and more healthy eating, and, maybe most important, a renewed prayer life, particularly including a meditative prayer such as Centering Prayer. Let God help you help yourself. 

  2. Is the ACE score of your own children high? If you are worried or are carrying guilt because of what happened in your home when you were raising your own children (whether or not it was your fault), this is a heavy burden. It doesn’t help you or them if you carry it around. I am learning this myself. Pray and surrender this burden to our loving God. Get help with therapy if you need to. Remember, parents are not responsible for the happiness of their adult children. We did the best we could. Just as our parents did.  And, just as our children will do.

  3. We can all work to prevent ACEs. The CDC gives an excellent overview of this topic from a societal approach. Even the presence of one caring person or one concerned adult outside of the family can make a big difference for a child can lessen the impact of the ACEs. Are you that friend, neighbor, doctor, nurse, or teacher? This can mean reaching out, going to a game, offering to babysit, or just taking extra time to listen. Check out Aces Connection and its faith community to get more ideas.

  4. Here is an indirect, yet very powerful, way we can mitigate  the impact of ACEs. If we find ourselves feeling judgmental about someone’s behaviors, attitudes, addictions, obesity, or habits, we need to remember ACEs. We have not walked in that person’s shoes…..and we do not know the terrible places  he or she may have walked.

How Adverse Childhood Experiences Affect Adult Illness


1. Check out the CDC site if you haven’t yet done so. It is an excellent resource for the basics

2. Whole People is a terrific 5-part series done by PBS to spotlight the impact of Adverse Childhood Experiences (ACEs) through stories about responses, healing and solutions. 

3.  Reflect on any judgmental feelings you may have. Let us all ask God to help us be less judgmental and more loving to those who are different from us in any way, including health, appearance, and behaviors.

Have you heard of ACEs before? If not, how did you react when you read this? I would love to hear from you. By the way, I am now on LinkedIn. Connect with me there or on Facebook or Twitter. Be sure to subscribe to my newsletter/blog.

God bless,