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Adverse childhood experiences and their relationships with health harming behaviors in adulthood

Being physically or sexually abused as a child or growing up in a home where there is domestic violence or other problems, such as alcohol or drug abuse, is linked with increased development of health harming behaviors throughout adult life according to research published in the open access journal BMC Medicine. Results from England’s first national Adverse Childhood Experience study show that the greater the number of adverse childhood experiences people suffer as a child the more likely they are to binge drink, be involved in violence and develop drug use (e.g. heroin/crack cocaine use) in adulthood.

Researchers from Liverpool John Moores University carried out the survey of 3885 people in England aged from 18 to 69. Participants were selected from 200 different geographical areas to give a nationally representative picture in terms of deprived/wealthy communities and ethnicity. People who participated in the study were asked which of nine different adverse childhood experiences they had suffered in their home environment during childhood. These included physical, sexual and verbal abuse, living with someone who had a mental illness, parental separation, having a household member incarcerated and domestic violence or substance use in the home environment.

The participants were then asked about current and historic involvement in nine different health harming behaviors, such as violence, sexual intercourse under 16 years, teenage pregnancy, smoking, alcohol consumption, cannabis and other drug use and diet.

Consistent with other studies, the English Adverse Childhood Experience survey also identified that deprivation was associated with higher levels of many health harming behaviors and so all results were adjusted to account for this and other associations. Even after accounting for deprivation those who experienced four adverse childhood experiences were three times as likely to smoke, six times as likely to have been pregnant or got someone pregnant unintentionally as a teenager, seven times as likely to have been involved in violence in the last year and 11 times more likely to have ever used crack cocaine or heroin, compared to those who experienced none.

Mark Bellis, lead author of the study, says: “The foundations for many of the health harming behaviors we see in adults are laid down during childhood. Adverse childhood experiences can affect the development of children’s brains, immune systems and ultimately set them on a health harming life course. This national survey shows a substantial proportion of individuals in England have experienced these stressful events in their childhood and such events may continue to affect their behavior as adults.”

Results from the national Adverse Childhood Experience survey show nearly half of adults in England experienced one adverse childhood experience during their childhood and 9% suffered four or more adverse childhood experiences. The research highlights the importance of addressing ACEs to improve the lives of the children affected and calculates that preventing adverse childhood experiences in England could help reduce problem drug use and violence in adults by up to 50%, those who have experienced teenage pregnancies by a third and also reduce levels of binge drinking and smoking by around 15%.

Mark Bellis says: “The importance of addressing adverse child events is often hidden, along with the voices of the children affected. We already know that the introduction of evidence-based interventions providing support for children and parents can help reduce adverse childhood experiences. A limited number of people, especially in deprived communities, receive such support in England. However, we need to ensure that parents, health practitioners and policy makers recognize the lifelong benefits that result from ensuring all children have safe and nurturing childhoods.”


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Notes to Editor

1. National household survey of adverse childhood experiences and their relationship with resilience to health-harming behaviors in England
Mark A Bellis, Karen Hughes, Nicola Leckenby, Clare Perkins and Helen Lowey
BMC Medicine 2014, 12:72

Article available at journal website here.

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