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Adverse Childhood Experiences (ACEs)

Shasta Community Health Center provides resource information on its website as a public service. The materials contained on this site are made available for educational purposes only and are not meant to serve as medical advice or to replace consultation with your physician or mental health professional. You are advised to consult your physician or mental health provider about your personal questions or concerns.


The Adverse Childhood Experiences Study(ACES)

The ACE Study is one of the largest investigations ever conducted to assess connections between chronic stress caused by early adversity and later-life health. The study began with a partnership between Kaiser Permanente and the U.S. Centers for Disease Control and Prevention. It looked at multiple categories of childhood physical and emotional abuse and neglect, as well as measures of household dysfunction like domestic violence, parental mental illness, substance abuse and separation/divorce.

The results of the ACE Study had two striking findings. First, ACEs are incredibly common—67 percent (2 out of 3 people) of the study population had at least one ACE and 13 percent (1 out of 8 people) of the population had four or more ACEs. Secondly, there was a dose-response relationship between ACEs and numerous health problems. This means that the more ACEs a child has, the higher the risk of developing chronic illnesses such as heart disease, chronic obstructive pulmonary disease (COPD), depression and cancer.

Research over the last two decades confirms that children carry the effects of childhood experiences into adulthood. The challenges they face in school, life and ultimately, the state of their health are often the symptoms of toxic stress. Toxic stress, unlike manageable stress, refers to the long-term changes in brain architecture and organ systems that develop after extreme, prolonged and repeated stress goes untreated. Exposure to ACEs may put our children at higher risk for learning difficulties, emotional problems, developmental issues and long-term health problems.

Effective screening and interventions can save children and their communities a lifetime of costly health issues, and the Center for Youth Wellness aims to serve as a national model for addressing exposure to ACEs. Our goal is to transform the way medicine responds to the challenges facing our children—especially in disadvantaged communities.

Looking to calculate your ACE score? Check out the tool on AcesTooHigh.


Toxic Stress

Imagine that you see a bear while walking through a forest. In response to this threat, your body switches into "fight or flight" mode. To survive, your body releases emergency stress hormones, like adrenaline and cortisol that cause your heartbeat to quicken, make your eyes dilate and focus your mind on the threat at hand—everything you need to get your body ready to run or to fight back. When activated occasionally, this system bypasses our thinking brain—the prefrontal cortex—and activates the primitive reactions that can get us out of the way of a mortal threat. In situations like this, stress is helpful—it keeps you alive.

The problem comes when our system is overtaxed by repeated, intense or chronic stress. That cascade of chemicals and reactions goes from saving one's life to damaging one's health. Children are especially vulnerable to the harmful effects of chronic stress and trauma. For many kids who are repeatedly exposed to Adverse Childhood Experiences, such as violence at home or in the community, or having a parent with mental illness or substance dependence, their "fight or flight" system is activated so often that it stays on. These high levels of emergency hormones can lead to changes in the structure and function of children's developing brains and bodies. The result is toxic stress.

Without support and protection from adults, children who experience toxic stress are at higher risk for health and social problems, like asthma, diabetes and obesity, as well as learning difficulties. Toxic stress also may make it difficult to sit still in school or to control emotions in challenging situations. If left untreated, toxic stress can lead to increased risk of adult diseases including heart disease and cancer.


What We're Doing

We are screening parents in the pediatric setting for the kinds of adversity that put them at risk for developing toxic stress and significant health problems later in life. Our experience has shown that if we can identify and assess risk early on, we have a better chance of offering interventions that prevent long-term health and behavioral problems.

Primary care providers develop a unique relationship with caregivers and children. The trust that many families feel for their child's doctor makes the primary care setting an essential place to screen for ACEs and begin the conversation with caregivers about potential risks to their child's health and well-being. Screening for ACEs is also an opportunity to educate families about the link between adversity and negative health outcomes and to make appropriate referrals for prevention and treatment.


Other Resources

Adverse Childhood Experiences (ACEs) Resources:

  • ACEs Shasta County - a brochure on ACEs in Shasta County and local resources
  • ACEs Too High - a news site that reports on research about adverse childhood experiences
  • ACEs Connection - a community of practice to prevent Adverse Childhood Experiences and to change systems to stop traumatizing already traumatized people.
  • The ACE Study - (CDC) Centers for Disease Control and Prevention

Toxic Stress Information:

Resources for Finding a Mental Health Provider:



Links to external websites are provided for convenience of reference only and are not intended as an endorsement by Shasta Community Health Center.