A new study has found that people who suffered multiple types of Adverse Childhood Experiences (ACEs) — such as physical, sexual, or emotional abuse, or other stresses, such as living in a household with domestic violence or with adult substance abuse or mental illness — are more than twice as likely to use hospital emergency departments, require overnight hospital stays, or be frequent users of doctors as adults.
The study of 7,414 adults in England and Wales compared those who suffered ACEs with those whose childhoods were ACE free. Researchers found that people with four or more ACEs showed substantially increased levels of health care use even as young adults (18-29 years) with these increases still apparent decades later.
In young adults with no ACEs, 12 percent needed to attend an emergency department in the last year, compared to 29 percent in those with four or more ACEs.
By the age of 60-69 years, 10 percent of individuals with no ACEs required at least one overnight hospital stay in the last year, compared to 25 percent of individuals with four or more ACEs.
According to the researchers, high levels of ACEs are common. In this general population sample, 10 percent of all adults had experienced four or more ACEs as a child.
The study, published in the Journal of Health Service Research & Policy, provides statistical evidence showing that, regardless of socio-economic class or other demographics, people who have adverse childhood experiences use more health and medical services through their lifetime.
The researchers conclude that investing in preventing or reducing adverse childhood experiences, as well as addressing the resulting trauma in those who have experienced ACEs, can help reduce future health service demand and costs.
“Even at the most basic biological levels, experiencing ACEs can change children, leaving them more likely to develop poor physical and mental health throughout their lives,” said Dr. Mark Bellis, a professor of public health at Bangor University’s College of Health & Behavioral Sciences.
“A safe and nurturing childhood is a recipe for building stronger, happier children, with a much greater chance of becoming healthy adults.
“Our results demonstrate that the more adverse experiences people suffer as a child, the more likely they are as adults to be frequent users of basic health services such as GPs and emergency services, as well as requiring more specialist overnight hospital support,” he said. “As costs of health care escalate in the UK and abroad, it is essential we take a life course approach to health that recognizes the problems we frequently see in adults begin with childhood traumas.”
“Adult risks of becoming smokers or heavy drinkers and of developing cancers, diabetes, and other life-threatening diseases are all increased in those with a history of childhood adversity,” added Professor Karen Hughes, a co-author of the paper. “This study shows how the health consequences of ACEs impact not just on the individual, but also on the health services that support them.
“Health professionals already play a substantive role in treating the life-long impacts of childhood adversity, but recognizing the role ACEs play in adult ill health should provide opportunities for better treatment and a greater focus on prevention.”