Fieldwork for the Welsh Adverse Childhood Experiences (ACE), Resilience and Health Survey

Descriptions

Adverse Childhood Experiences (ACEs) are stressful events occurring in childhood that either affect a child directly (e.g. being a victim of physical or sexual abuse) or affect the environment in which they grow up (e.g. living in a household with domestic violence, substance abuse or mental illness). A wide range of international research shows that exposure to ACEs can have long lasting impacts on peoples’ physical and mental health, contributing to the development of harmful lifestyle behaviours, chronic disease and premature mortality.In 2015, Public Health Wales undertook the first ACE study in Wales to identify the prevalence of ACEs among the general adult population and their impact on current health problems. The survey found that almost half of all adults in Wales experienced at least one ACE during their childhood and around one in ten suffered four or more ACEs. There were strong, cumulative relationships between ACEs and health; the more ACEs individuals reported having suffered the more likely they were to engage in health harming behaviours such as smoking, drug use, risky sexual behaviour and violence and to have poor mental health and chronic health conditions such as diabetes, cancer, heart disease and respiratory disease. Greater childhood adversity was also associated with greater use of health services.While exposure to ACEs can damage individuals’ health prospects across the life course, many individuals who suffer ACEs manage to avoid such negative effects; a characteristic known as resilience. Resilience is the ability to transform potentially toxic stress (such as that associated with chronic childhood adversity) into tolerable stress and therefore reduce the harmful physiological and psychological impacts of such stress occurring during childhood development. During childhood, factors contributing to the development of resilience include supportive adult relationship, social skills development and the supportive context of cultural traditions. Resilience appears to be an asset that can be developed prior to, during and after exposure to childhood adversity and factors such as strong personal relationships and social support networks are important resiliency resources throughout the life course.The findings from the 2015 Welsh ACE Survey are supporting the development of national and local policy and practice to prevent ACEs and develop responsive services that recognise the underlying causes of harmful behaviours and health conditions. This second survey seeks to further this work by developing understanding of the resiliency resources in childhood and adulthood that can protect against the impact of ACEs and the development of poor health. The findings will be used to influence and develop national and local childhood and family-based policies and practices, thereby aiming to prevent future ACEs, as well as to minimise their impacts on population health. The availability of such data for Wales will support: investment in prevention and health improvement; the development, implementation and monitoring of local early years’ strategies and plans; and better targeting and commissioning of interventions to reduce inequalities and improve health outcomes.