Adverse Childhood Experiences (ACEs) include abuse and neglect, and measures of family dysfunction such as parental substance misuse, intimate partner violence, psychiatric disorders, and separation. People who experience ACEs are more likely to develop adverse health-related behaviours and poor physical and mental health.

There is increasing awareness of the role that adverse childhood experiences (ACEs) can play in influencing poor health-related behaviours, physical, and mental health. The definition of ACEs varies between studies, but the adversities most commonly studied include child maltreatment (e.g., emotional, physical, and sexual abuse; physical or emotional neglect) and measures of household dysfunction (e.g., violence between parents, parental separation and parental substance misuse, mental illness, or criminal behaviour).
ACEs are rising rapidly on policy agendas, and there is a drive within public health and other spheres of public policy to prevent ACEs, develop and implement interventions to support people who have experienced ACEs, promote ACE-aware services, and even to screen people for the number of ACEs they have encountered. The ACEs framework has led to considerable financial investment from the public sector.
ACEs are more common in people living in poverty. We also know that poverty, adversity, and poor health tend to pass down across the generations within a family. This means that if we simply look at the association between ACEs and health, without fully accounting for the broader family context, this may exaggerate the effect of ACEs on health. Yet this is exactly what is done in the majority of scientific research on ACEs. There are very few studies that try to look at whether ACEs actually cause poor health. If we really want to understand how ACEs are influencing health and use this information to design effective policies and interventions with scarce public resources, we need higher-quality evidence.

In this project, we will improve the quality of evidence on whether ACEs causally affect health by analysing data from ALSPAC, which has followed up children and their families across their lives. We will use information about health before and after an ACE has happened, to see whether the ACE led to a change in health, i.e. whether the ACE ‘derails’ someone from the health trajectory they were already on. We can also use information about other ACEs that happened earlier in life, or even ACEs that happened to the parents when they were children. We will look at whether ACEs influence health-related behaviours (smoking, alcohol use, drug use, and physical activity), physical health (obesity, and the health of the heart and lungs), and mental health.