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