Who We Are…• Kids Oneida
• Upstate Cerebral Palsy
• Oneida County Planning; DSS; Health/Mental Health
• SUNYIT
• Utica College
• Family Nurturing Center
• Dr. Lark Eschelman- Patterson & Bob Patterson
• Peg Zimmerman
• Honorable Ralph Eannce
• Robin O’Brien – USCare
• Gina Ashmore – Hospice
The Adverse Childhood Experiences (ACE) Study
Examines the health and social effects of ACEs throughout the lifespan among 17,421 members of the Kaiser Health Plan in San Diego County
What do we mean by Adverse Childhood Experiences?
- childhood abuse and neglect- growing up with domestic violence, substance abuse or mental illness in the home, parental discord, crime
Goals Of The Local Efforts:
• Reinforce awareness– Linking ACES to physical and mental health
• To ascertain perceived needs in the community and collect information on who professionals are referring to now
• To solicit help and recommitment for the vulnerable youth in Oneida County
What Are ACES(Adverse Childhood Experiences)
• Emotional/Physical Abuse
• Sexual Abuse
• Emotional/Physical Neglect
• Domestic Violence – Battered Mother
• Single Parent Homes – Due to Separation/ Divorce/Death
• Substance Abuse - One or Both Parents
• Incarcerated Parent(s)
• Parent(s) Suffering From Mental Illness
• Parent(s) Suffering From Chronic Illness
Adverse Childhood Experiences Are Common
Substance abuse 27%Parental sep/divorce 23%Mental illness 17%Battered mother 13%Criminal behavior 6%
Household dysfunction:
Abuse: Emotional 11% Physical 28% Sexual 21%
Neglect: Emotional 15% Physical 10%
Adoption of Health-risk Behaviors
Social, Emotional, & Cognitive Impairment
EarlyDeath
Adverse Childhood Experiences
Death
Disease, Disabilityand Social Problems
Conception
Scientific gaps
What We Know
ACEs tend to come in groups…
Additional ACEs (%) 1 2 3 4 >5
If you had:A battered mother 95 82 64 4852
Adverse Childhood Experiences ScoreTrauma “Dose”
Number of individual types of adverse childhood experiences were summed… ACE score Prevalence 0 33% 1 26% 2 16% 3 10%4 or more 16%
Prevalence of Childhood Abuse by Frequency of Witnessing Domestic Violence
Prevalence of Childhood Abuse by Frequency of Witnessing Domestic Violence
Childhood AbuseEmotional Physical Sexual
0
20
40
60
80
100
NeverOnce,TwiceSometimesOften Very often
Frequency of witnessing domestic violence
Per
cen
t (%
)
0
2
4
6
8
10
12
14
16
18
20
Per
cen
t W
ith
Hea
lth
Pro
ble
m
(%) 0 1 2 3 4 or more
ACE Score
Early smokinginitiation
Current smoking COPD
ACEs, Smoking, and Lung Disease
ACE Score and HIV Risks
0
2
4
6
8
10
12
14
16
18
20
Perc
en
t W
ith
Healt
h P
rob
lem
(%
)
0 1 2 3 4 or moreACE Score
Ever Injected Drugs
Had 50 or MoreIntercourse Partners
Ever Had an STD
The ACE Score and the Prevalence of Severe Obesity
0
2
4
6
8
10
12
14
0 1 2 3 >=4
ACE Score
Perc
en
t ob
ese (
%)
The ACE Score and the Prevalence of Liver Disease (Hepatitis/Jaundice)
0
2
4
6
8
10
12
0 1 2 3 >=4
ACE Score
Perc
en
t (
%)
The ACE Score and the Prevalence of Attempted Suicide
0
5
10
15
20
0 1 2 3 >=4
ACE Score
Perc
en
t ate
mp
ted
(%
)
The ACE Score and a Lifetime History of Depression
0
10
20
30
40
50
60
70
0 1 2 3 >=4
Women Men
ACE Score
Perc
en
t d
ep
ressed
(%
)
ACE Score and theRisk of Being a Victim of Domestic
Violence
0
5
10
15Women Men
0 1 2 3 4 >5 0 1 2 3 4 >5
Ris
k o
f V
icti
miz
atio
n
(%)
ACE Score
ACE Score and Rates of Antidepressant Prescriptions
0
10
20
30
40
50
60
70
80
90
100
ACE Score
0 1 2 3 4 >=5
P
resc
rip
tio
n r
ate
(p
er
10
0 p
ers
on
-ye
ars)
ACE Score and Rates of Prescribed Antidepressant Medications by Age, 1997-2004
1Relative rates are adjusted for age, sex, race/ethnicity, and education. Adults with an ACE Score of 0 are the referent.
0
20
40
60
80
100
120
140
0 1 2 3 4 5+ 0 1 2 3 4 5+ 0 1 2 3 4 5+
Rat
e pe
r 100
P-Y
ACE Score
45-64 yrs
ACE Score
18-44 yrs
ACE Score
65-89 yrs
Adverse Childhood Experiences As a National Health and Economic
Issue
ACEs have a strong influence on:-adolescent health
-reproductive health-smoking
-alcohol abuse-illicit drug abuse-sexual behavior-mental health
- risk of revictimization-stability of relationships, homelessness
-performance in the workforce
Adverse Childhood Experiences As a National Health Issue
ACEs increase the risk of:-Heart disease
- Chronic Lung disease- Liver disease
- Suicide - Injuries
-HIV and STDs- and other risks for the leading
causes of death
The Adverse Childhood Experiences (ACE) Study
- These strength of these findings indicate that:
Adverse Childhood Experiences are a leading determinant of health and social well-being of from adolescence to late adulthood
ACE Study websitewww.cdc.gov/nccdphp/ACE
Adverse Childhood Experiences Rarely Occur in Isolation…
They come in groups.
Domestic Violenceand the Risk of Other ACEs...
ACEs and Prescriptions
for Antidepressant Medication
ACEs and the Risk of Domestic Violence as an Adult..
A Cycle…
Kids Oneida
Study on Adverse Childhood Experiences 9/07
*3 or less indicators: 28%*4 or more indicators: 72%
ACE Indicators
4% 10%
14%
14%13%
18%
15%
10% 2%1 ACE Indicator
2 ACE Indicators
3 ACE Indicators
4 ACE Indicators
5 ACE Indicators
6 ACE Indicators
7 ACE Indicators
8 ACE Indicators
9 ACE Indicators
*3 or less indicators: 30%*4 or more indicators: 70%
ACE Indicators in Males
5% 8%
17%
13%16%
14%
15%
10% 2%
1 ACE Indicator
2 ACE Indicators
3 ACE Indicators
4 ACE Indicators
5 ACE Indicators
6 ACE Indicators
7 ACE Indicators
8 ACE Indicators
9 ACE Indicators
*3 or less indicators: 21%*4 or more indicators: 79%
ACE Indicators in Females
3% 13%
5%
18%
5%29%
16%
11% 0%1 ACE Indicator
2 ACE Indicators
3 ACE Indicators
4 ACE Indicators
5 ACE Indicators
6 ACE Indicators
7 ACE Indicators
8 ACE Indicators
9 ACE Indicators
65
7667
96
107
55
79
48
29
0
20
40
60
80
100
120
Nine Indicators
Neglect
Domestic Violence
Substance Abuse
Mental Illness in Home
Parental Separation
Incarceration
Emotional Abuse
Physical Abuse
Sexual Abuse
Number of Open Cases 9/07 = 120 Studied
Of Interest:
* ACE Study 14% had 4 or more ACE Indicators*ACE Study : 1 in 10 had 5 or more ACE’s*More common for indicators to occur in groups*Higher ACE score leads to health risks: -more alcohol abuse/alcohol related health issues -more tobacco-related health issues -higher risk of illicit sexual behavior and STD’s -higher risk of suicidal ideation/depression - Huge increases in cost over a a life time
Body Stress System
Stress Illness Relationships
Taken from Taylor, 2006
Stress Illness Relationships
Taken from Taylor, 2006