It’s an overworked stereotype that a psychiatrist trying to get to the root of his patient’s mental problems will begin by saying: “Tell me about your childhood…”
But now there is strong evidence from a new study that traumatic experiences in childhood will directly affect not just mental health, but physical wellbeing in later life. The new research, by Public Health Wales, suggests that children who suffer repeated adverse experiences are three times more likely to develop chronic illnesses such as lung and heart disease in later life.
The work looks at ‘Adverse Childhood Experiences’ (ACEs) including verbal, physical and sexual abuse, parents splitting up, households blighted by domestic abuse, heavy drinking, drug abuse and mental illness, or households where a family member is in prison. From its study group of more than 2,000 adults in Wales, it found that a reassuring 53% had suffered none of these ‘ACEs’, but 20% reported one ACE, 13% had two-to-three, and 14% had four or more.
It was members of this last group who were of greatest concern, since the research found they were:
· Four times more likely to develop type 2 diabetes than a child with no ACEs
· Three times as likely to have spent a night in hospital or visited A&E in a 12-month period
· Twice as likely to be frequent visitors to their GP.
The research also found that by the age of 49, a quarter of those in the four-or-more ACEs group were diagnosed with one or more chronic diseases, compared with just 6.9% of those in the group reporting no ACEs.
While it’s nothing new to suggest that a good start in life will bring benefits later on, the Public Health Wales (PHW) research demonstrates a clear link between negative childhood experiences and ill health in later life. It does not prove that one directly causes the other, as many other social factors need to be considered. For example, a household with an unusually high incidence of ACEs might also be one with an inadequate diet, poor hygiene or general neglect, all of which could also impact on health in later life.
But the research does show that the number of ACEs a child suffers is a strong indicator of future poor health, unless there is some form of intervention to prevent it.
Professor Mark Bellis, PHW’s director of policy and research, said: “Most of us have the odd shock in childhood and after that we relax and we're comforted by parents and our bodies develop at that lower, more relaxed level. But if you get constant exposure to adverse childhood experiences, your body develops at a higher state of tension, it's always looking out for more threats.
"That means as your body develops, it's used to being ready to be injured or hurt in some way and it wears out quicker. You're also more ill at ease, you may develop poorer metal health, you're more likely to use alcohol and drugs – and they increase your risks of ill health later on in life. All that adds up to you developing poor health, earlier."
And the research doesn’t just raise questions and challenges for the NHS. It also found that children who had four or more ACEs were 15 times more likely to become perpetrators of violence themselves, and 14 times more likely to be a victim.
Again, it’s nothing new to suggest that those raised in a particular type of environment will go on to recreate that environment in their own later life. Those who suffered violence at the hands of their parents are more likely to be violent towards their own children; those who grew up in families where heavy drinking was prevalent are more likely to have issues with alcohol abuse, and so on. The challenge for society is how to break that cycle of repetition.
Prof. Bellis added: “The long-term costs of leaving these things untreated are enormous. What we’ve got to focus on is this; instead of mending broken adults we must build stronger children.”