# Tarheel Health Portal/Adverse Childhood Experiences and Adulthood Morbidity

Medical sociologists have long studied the clear association between adverse childhood experiences and adulthood morbidity. Adverse childhood experiences refer to any event that may have traumatic effects on one’s childhood. Some examples include child abuse, the death of a loved one, growing up in poverty, or being a victim of sexual abuse. Research has shown that such traumatic incidences in childhood have been linked to an increased prevalence of certain physical diseases in adulthood. These diseases include chronic cardiovascular disease, type 2 diabetes and obesity amongst many others. However, there is still little known in regards as to why this association between adverse childhood experiences and adulthood health exists at all. Researchers have proposed that the advanced shortening of the DNA's telomeres may be the link between these two variables. With little public attention drawn to this troubling occurrence, victims of adverse childhoods may not be aware that their physical health may be in jeopardy. Therefore, it is necessary that individuals are aware of the long-lasting impact of adverse childhoods in order to preserve their health and the health of others.

## What are Adverse Childhood Experiences?

Adverse childhood experiences, more commonly known as ACEs, refer to difficult or traumatic events occurring in one's life before the age of eighteen. Synonymous phrases to adverse childhood experiences include childhood misfortune, childhood trauma, and adverse childhoods. Some examples of adverse childhood experiences are listed below. By no means is this list a complete and comprehensive list of all events categorized as adverse childhood experiences.
Examples of Adverse Childhood Experiences:
* Child abuse (Physical and Mental)
* Having a chronically ill loved one
* Growing up in poverty
* Losing a loved one (parent, sibling, etc.)
* Many other events not listed
An ACE score refers to the quantity and severity of adverse childhood experiences one may have endured. A link to determine your personal ACE score can be found in the Further Readings and Resources section.

## The Life Long Effects of ACEs

Studies have shown that individuals that have suffered through adverse experiences in childhood have a greater risk for various physical illnesses in adulthood. However, these studies do not state that just because an individual was a victim of a traumatic childhood that they will undoubtedly experience a physical illness in adulthood. Instead, as previously stated, these studies show that adverse childhood experiences increases an individual's chance of suffering from one of these illnesses. In a 2004 study that explored childhood maltreatment as a risk factor for adult cardiovascular disease, it was found that women that were subjected to childhood trauma were nine times more likely to develop cardiovascular disease than women who reported never having experienced significant childhood adversity. A similar study tested the association between ten different adverse childhood experiences and heart disease. Not only did this study find that all but one of the adverse childhood experiences tested increased the likelihood of heart disease, but that the experience of childhood trauma was a stronger risk factor for ischemic heart disease than factors like a poor diet and smoking. Studies that deal with health consequences other than cardiovascular disease found that individuals subjected to such experiences have been shown to have a higher propensity for obesity along with an upwards of 50% chance of developing type two diabetes. A study published in the Journal of Psychosomatic Medicine explored the increased prevalence of autoimmune diseases in adults that have undergone adverse childhood experiences.. When exposed to more than one childhood experience, individuals were shown to be almost 100% more susceptible to debilitating rheumatic diseases, such as arthritis. A 2012 study conducted by researchers at Purdue University also found that additive childhood misfortune, physical abuse by the father, and frequent abuse by either parent increased the risk factor of men developing cancer in adulthood. For women, physical abuse by the mother and frequent abuse by either parent increased cancer risk.

## Telomere Shortening as a Biological Mechanism

Although the association between adverse childhood experiences and adulthood health is well supported, its main cause is still unknown. How is it that the environmental influence of adverse childhood experiences is able to have consequential biological effects? Recently, certain researchers have investigated the role that telomeres may have in this association. Telomeres, composed of combinations of DNA and protein, are located at the end of chromosomes. Acting analogously to the plastic tip of a shoelace, telomeres provide protection and stability for chromosomes. However, as one ages, the length of their telomeres decreases which results in an increase in cell aging. Eventually, telomeres become too short, resulting in cell death, which has been shown to negatively impact one’s health. Medical sociologists have proposed that stressful events in childhood may contribute to the shortening of telomeres and consequently advance cellular aging. A study conducted in 2011 observed that those reporting to have experienced childhood adversity were found to have telomeres that were on average .64 Kb shorter than individuals who had a childhood that was absent of adversity.This difference in telomere length is equivalent to a 15 year shorter predicted lifespan for victims of childhood trauma compared to their counterparts that reported not having undergone adverse childhood experiences. This telomere erosion is abrupt and can begin very soon after the initial incidences of prolonged childhood adversity. It was revealed through a study of five to ten year-old victims of childhood trauma that not only did they experience telomere erosion at a very young age, but that this erosion was rapid and progressive.

## Why Does this Matter?

Currently, the general public seems to be unaware of the troubling notion that adverse childhood experiences may potentially influence one's health in adulthood. It's extremely unfortunate to see the long-term effects that adverse childhood experiences have on their victims. Although it's not certain, individuals that have suffered through traumatic events may have an increased susceptibility to debilitating chronic illnesses such like heart disease and diabetes. Because of this, it may be beneficial for individuals to seek support and professional resources to help deal with the scars left by adverse childhood experiences. Group counseling sessions along with many other resources are available through the university’s department of Campus Health and Wellness. For those who seek to learn more about adverse childhood experiences and their consequences, it may be worthwhile to take a look at the research on adverse childhood experiences that is being conducted here at UNC's Frank Porter Graham Child Development Institute. Links to the University’s Campus Health site and links to the university’s research on adverse childhood experiences can be found under Further Readings and Resources.

## Further Readings and Resources
### Further Reading on ACEs studies

CDC Studies
The ACE Study
ACE Score Quiz Find out your ACE score
The ACE Test - Assessing Childhood Adversity

### Resources for Victims of ACEs

UNC Chapel Hill: Campus Health Counseling and Psychological Services
UNC Chapel Hill: Campus Health Group Therapy
NC Hopeline: Crisis Line

### Resources for Those Interested in Research

Research Conducted by UNC's Frank Porter Graham Child Development Institute:Adverse Childhood Experiences, Dispositional Mindfulness, and Adult Health
Research Conducted by UNC's Frank Porter Graham Child Development Institute:Mindfulness Helps Adults Overcome Childhood Adversity
Research Conducted by UNC's Frank Porter Graham Child Development Institute: Mental and Emotional Health