Epidemiological and biomedical evidence link adverse childhood experiences (ACEs) with healthharming behaviours (HHB) and the development of non-communicable disease in adults. A nationally representative survey of English residents aged 18 to 69 (n = 3,885) was undertaken during the period April to July 2013. Individuals were categorised according to the number of ACEs experienced. Modelling identified the proportions of HHBs (early sexual initiation, unintended teenage pregnancy, smoking, binge drinking, drug use, violence victimisation, violence perpetration, incarceration, poor diet, low levels of physical exercise) independently associated with ACEs at national population levels. 47% of individuals experienced at least one of the nine ACEs.

Prevalence of childhood sexual, physical, and verbal abuse was 6.3%, 14.8%, and 18.2% respectively (population-adjusted). After correcting for sociodemographics, ACE counts predicted all HHBs, e.g. (0 versus 4+ ACEs, adjusted odds ratios (95% confidence intervals)): smoking 3.29 (2.54 to 4.27); violence perpetration 7.71 (4.90 to 12.14); unintended teenage pregnancy 5.86 (3.93 to 8.74). Modeling suggested that 11.9% of binge drinking, 13.6% of poor diet, 22.7% of smoking, 52.0% of violence perpetration, 58.7% of heroin/crack cocaine use, and 37.6% of unintended teenage pregnancy prevalence nationally could be attributed to ACEs. Stable and protective childhoods are critical factors in the development of resilience to health-harming behaviours in England. Interventions to reduce ACEs are available and sustainable, with nurturing childhoods supporting the adoption of healthbenefiting behaviours and ultimately the provision of positive childhood environments for future generations.

Source: National household survey of adverse childhood experiences and their relationship with resilience to health-harming behaviours in England. M Bellis, K Hughes, N Leckenby, C Perkins and H Lowey. BMC Medicine. Published 2 May 2014. www.biomedcentral.com/1741-7015/12/72