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Adverse Childhood Experiences and their impact on health-harming behaviours in the Welsh adult population

Welsh Adverse Childhood Experiences (ACE) Study

An increasing body of research identifies the long-term harms that can result from chronic stress on individuals during childhood. Such stress arises from the abuse and neglect of children but also from growing up in households where children are routinely exposed to issues such as domestic violence or individuals with alcohol and other substance use problems.

Collectively such childhood stressors are called ACEs (Adverse Childhood Experiences). Exposure to ACEs can alter how children’s brains develop as well as changing the development of their immunological and hormonal systems. Subsequently, those with greater exposure to ACEs are more likely to go on to develop health-harming and anti-social behaviours, often during adolescence, such as binge drinking, smoking and drug use. Ultimately, such poor health and social behaviour means individuals progress more rapidly to develop diseases such as diabetes, cancer, cardiovascular disease and mental illness.

Preventing ACEs can improve health across the whole life course, enhancing individuals’ well-being and productivity while reducing pressures and costs on the National Health Service (NHS). Those experiencing more ACEs are also more likely to be involved in violence and other anti-social behaviour and perform more poorly in schools. Thus, health, social, criminal justice and educational systems are all likely to see better results for the Welsh population if ACEs are prevented.

Tackling ACEs in Wales relies on having intelligence on how many individuals are exposed to ACEs, the characteristics of those most at risk and the consequences across the life course. Consequently, in 2015, Public Health Wales in collaboration with Liverpool John Moores University undertook the first ACE study for Wales which consisted of a national cross-sectional survey of adults residential in Wales. With an overall sample size of 2,028, Welsh adults were asked about their current health behaviours and their exposure to ACEs using an internationally validated ACE questionnaire. Initial analysis of the study has focused on identifying how health-harming behaviours (for example, drug use and binge drinking) are linked with experiencing ACEs during childhood. Full details of the methodology and results are contained in this report and a summary of the findings is presented as an info-graphic.

This first Welsh ACE survey identifies that substantial proportions of the Welsh population suffered abuse, neglect and other ACEs during their childhood with 47% reporting having experienced at least one ACE and 14% experiencing four or more ACEs. However, the report also outlines a substantive range of policies and programmes that have now been implemented in Wales to both prevent ACEs and identify and intervene where children are already experiencing such stressors.

Findings show that ACEs have a major impact on the development of health-harming behaviours in Wales and the prevention of ACEs is likely not only to improve the early years experiences of children born in Wales but also reduce levels of health-harming behaviours such as problem alcohol use, smoking, poor diets and violent behaviour. Further reports from this survey will detail how ACEs in Wales are associated with chronic ill health in later life such as the development of cancer, heart disease, diabetes and ultimately premature death.