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Adverse childhood trauma such as divorce, abuse linked to leading causes of death, CDC says

Adverse childhood trauma such as divorce, abuse linked to leading causes of death, CDC says

A general view of the Centers for Disease Control and Prevention (CDC) headquarters in Atlanta, Georgia. | Reuters/Tami Chappell

Adverse Childhood Experiences such as divorce, racism, witnessing violence, substance abuse or having a parent in jail have now been linked to at least five of the 10 leading causes of death in America, according to a recent report from the Centers for Disease Control and Prevention.

Preventing them, the report says, could help lead to healthier and longer lives while saving hundreds of billions of dollars annually in healthcare.

Adverse Childhood Experiences, as noted in a report on the CDC’s findings, Identifying and Preventing Adverse Childhood Experiencespublished in the Journal of the American Medical Association, are potentially traumatic events that occur in childhood and adolescence, such as experiencing physical, emotional, or sexual abuse; witnessing violence in the home; having a family member attempt or die by suicide; and growing up in a household with substance use, mental health problems, or instability due to parental separation, divorce, or incarceration.

The analysis, also reflected in the agency’s most recent Vital Signs report, suggests exposure to ACEs can result in extreme or repetitive toxic stress responses that can cause both immediate and long-term physical and emotional harms such chronic diseases, risky health behaviors, and socioeconomic challenges later in life.

“ACEs are associated with increased risk for numerous negative outcomes, including a wide range of chronic diseases and leading causes of morbidity and mortality, such as cancer, diabetes, heart disease, suicide, and drug overdose. Risk is particularly pronounced for individuals who experience multiple types of ACEs,” the CDC researchers note.

“ACEs are also associated with negative effects on educational achievement and employment potential. Importantly, the historical and ongoing effects of racism or poverty, living in under-resourced or racially segregated neighborhoods, and experiencing housing or food insecurity (social determinants of health) can contribute to and exacerbate the effects of ACEs,” they add. “The potential societal costs of ACEs are estimated to be in the hundreds of billions of dollars each year, with a significant proportion of these costs occurring in the health care system.”

The analysis examined the associations between ACEs and 14 negative outcomes using data from 25 states that included ACE questions in the Behavior Risk Factor Surveillance System from 2015 through 2017. State survey data were also used to estimate long-term health and social outcomes in adults that contribute to leading causes of illness and death and reduced access to life opportunities.

“We now know that adverse childhood experiences have a significant impact on an individual’s future health,” CDC Director Dr. Robert R. Redfield said in a release Tuesday. “Preventing traumatic experiences in childhood and initiating key interventions when they do occur will lessen long-term health consequences and benefit the physical and emotional well-being of individuals into adulthood.”

Key findings identified by the CDC showed that adults reporting the highest level of ACEs exposure had increased odds of having chronic health conditions, depression, current smoking, heavy drinking, and socioeconomic challenges like current unemployment, compared to those reporting no ACEs.

Women, American Indian/Alaskan Natives, and African Americans/blacks were also found more likely to experience four or more ACEs while the report noted that one in six people across the United States has experienced four or more kinds of ACEs.

Preventing ACEs, says the CDC, could reduce the number of adults who had heart disease by as much as 13% — up to 1.9 million avoided cases based on 2017 national estimates. Prevention could also reduce overweight or obesity by as much as 2% or up to 2.5 million cases using the same 2017 estimates. Depression could also be reduced by 44% or 21 million cases.

While the CDC is still working to prevent and reduce the negative impact of ACEs, the agency is now pushing education campaigns about the problem. Employers are also being encouraged to adopt and support family-friendly policies such as paid family leave and flexible work schedules, among other things.

“CDC encourages communities to take advantage of the best available evidence and join CDC in efforts to prevent ACEs. Everyone can help: Parents, teachers and school counselors, religious leaders, business leaders, health care professionals, and charitable organizations,” the agency said.


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