ACEs and Resilience

What are ACEs and How Do They Impact Health?

Adverse childhood experiences (ACEs) are characterized by 10 common childhood traumas in three categories identified by doctors and surveyed by the Centers for Disease Control and Prevention (CDC) and Kaiser Permanente:

  • Abuse: physical, emotional and sexual
  • Neglect: physical and emotional
  • Household challenges: mental illness, violence against mother; divorce; incarcerated relative; substance abuse

ACEs have a significant, long-term impact on health, quality of life, economics and education. Research shows that ACEs are common and affect all income levels.






“The child may not remember, but the body remembers.”


From the documentary Resilience: The Biology of Stress and The Science of Hope.

ACEs are the biggest determinant of health and social outcomes identified to date – bigger than healthy eating or physical activity (although both of those are parts of the “antidote” that build resilience and improve outcomes).

It is important to note that it is not which specific traumas someone has experienced, but how many. That is what impacts health.

Kaiser Permanente, which conducted the original study of ACEs in San Diego in the 1990s, found that 70% of the population surveyed in doctors’ offices had one or more ACEs. As the number of ACEs increased, health problems (and costs) did as well. With three ACEs, the risk for heart disease and depression goes through the roof. Six or more ACEs reduce life expectancy by 20 years.


Learn more about the statistics and resources.

The good news is that there are actions we ALL can take to turn these outcomes around.


The antidote to ACEs: building resilience.


Research shows that the presence of even one stable, caring adult in a child’s life is key to building resilience and mitigating the impact of ACEs.

Together, we as a community can work to prevent ACEs and mitigate their impact for a healthy, thriving and economically strong Wake County.

“ACEs are not destiny … they are a tool for understanding the health of a population as a whole. For individuals, an ACE score can be a tool for understanding their own risk for health and social problems, and empower them to make changes for themselves and their children.”

Dr. Robert Anda in the film Resilience

The ACEs Resilience Initiative Focus on Racial Equity

Since the initial meetings of theformer ACEs Resilience in Wake County Initiative was launched in 2017, partners had a desire to name racism as a current form of violence perpetrated against people of color and to inform the connection of trauma-informed practice and the trauma experienced by people of color.

To increase resilience in our community without understanding how race and ethnicity impact feelings of safety is incomplete and will not yield the desired results.

Initiative members have stated the importance of understanding equity and applying a racial equity lens to their work to ensure the following:

1) No additional harm is done to marginalized community members in the pursuit of building resilience;

2) Policy and practice solutions are relevant and benefit all community members;

3) Leadership of the initiative is reflective and inclusive of the diverse community members in Wake County; and

4) There is alignment with recommendations from the Wake County Community Health Needs Assessment and Population Health Task Force.

Find background information on racism, as well as a racial equity resource list, here.

What’s Next?


Want to learn more about ACEs and the nationwide movement to build resilience in our communities, including right here at SAFEchild and throughout Wake County? What are your next steps?


Watch Dr. Nadine Burke-Harris’ TED talk How Childhood Trauma Affects Health Across a Lifetime for a great, short overview of the link between childhood adversity and long-term risks to physical and mental health.


If you are interested in taking the ACEs questionnaire, find it here.


Find support for yourself or a loved one by following this link to a document listing local and online resources.


– To learn more about ACEs and join us in helping to build resilience within our community, follow this link to a document listing suggestions for next steps.