Examining relationships between adverse childhood experiences and coping during the cost-of-living crisis using a national cross-sectional survey in Wales, UK

Adverse childhood experiences (ACEs) are stressful experiences during childhood such as child maltreatment and exposure to household difficulties including domestic violence, substance abuse, mental illness and family members being in prison. This study analysed data collected from 1,880 adult residents across Wales. It found that those who reported multiple ACEs in their childhood were significantly more likely to perceive they would be unable to cope financially during the cost-of-living crisis, independent of factors including household income level, employment status and residential deprivation.

Authors: Karen Hughes, Mark Bellis+ 4 more
, Katie Cresswell, Rebecca Hill, Kat Ford, Joanne C. Hopkins

Adverse childhood experiences and engagement with healthcare services: Findings from a survey of adults in Wales and England

Adverse childhood experiences (ACEs) are associated with poorer health outcomes yet their association with healthcare engagement remains relatively underexplored, particularly within the UK. This report presents the findings of an online survey with adults resident in Wales and England, developed to explore the association between ACEs and healthcare engagement, including comfort in the use of healthcare services.

Authors: Kat Ford, Karen Hughes+ 3 more
, Katie Cresswell, Rebekah Amos, Mark Bellis

A practical handbook on Adverse Childhood Experiences (ACEs) Delivering prevention, building resilience and developing trauma-informed systems: A resource for professionals and organisations

This new resource aims to support action on ACEs by providing practical advice on implementing work to prevent ACEs, build resilience, and develop trauma-informed organisations, sectors and systems. It supports the development of a trauma-informed society that is invested in action to prevent ACEs and better support those affected by them.

Authors: Sara Wood, Hayley Janssen+ 3 more
, Karen Hughes, Jonathon Passmore, Mark Bellis

Preventing Sexual Violence In The Night Time Economy: Encouraging Men To Be Active Bystanders

#SafeToSay seeks to prevent sexual harassment through encouraging prosocial bystander responses towards sexual harassment or its warning signs in night life spaces.

Building on the evaluation of Phase One of #SafeToSay, Phase Two was delivered by the Wales Violence Prevention Unit, with funding from the South Wales Police and Crime Commissioner, as part of the Home Office Safety of Women at Night (SWaN) fund.

This evaluation has used findings from social media and website analytics, as well as the responses to a post-campaign public perception survey.

Authors: Alex Walker, Bryony Parry+ 2 more
, Emma Barton, Lara Snowdon

Measuring changes in adult health and well-being during the COVID-19 pandemic and their relationship with adverse childhood experiences and current social assets: a cross-sectional survey

Adverse childhood experiences (ACEs) can impact mental and physical health, leaving people with less resilience to health challenges across the life-course. This study examines whether individuals’ levels and changes in levels of mental health, physical health and sleep quality reported across the first year of the COVID-19 pandemic are associated with ACEs and moderated by social assets such as having trusted family and friends.

Authors: Mark Bellis, Karen Hughes+ 2 more
, Kat Ford, Helen Lowey

ACEtimation-The Combined Effect of Adverse Childhood Experiences on Violence, Health-Harming Behaviors, and Mental Ill-Health: Findings across England and Wales

Adverse childhood experiences (ACEs) encompass various adversities, e.g., physical and/or emotional abuse. Understanding the effects of different ACE types on various health outcomes can guide targeted prevention and intervention. We estimated the association between three categories of ACEs in isolation and when they co-occurred. Specifically, the relationship between child maltreatment, witnessing violence, and household dysfunction and the risk of being involved in violence, engaging in health-harming behaviors, and experiencing mental ill-health.

Authors: Rebekah Amos, Katie Cresswell+ 2 more
, Karen Hughes, Mark Bellis

Is parental unemployment associated with increased risk of adverse childhood experiences? A systematic review and meta-analysis

Unemployment has adverse consequences for families and can put children at risk of harm. This review examines associations between parental unemployment and adverse childhood experiences (ACEs). Findings highlight that increasing employment opportunities and parental support interventions may help break multigenerational cycles of ACEs.

Authors: Natasha Judd, Karen Hughes+ 3 more
, Mark Bellis, Katie Hardcastle, Rebekah Amos

Comparing relationships between single types of adverse childhood experiences and health related outcomes across the life course: a combined primary data study of eight surveys

Adverse childhood experiences (ACEs) show strong cumulative associations with ill-health across the life course. Harms can arise even in those exposed to a single ACE type but few studies examine such exposure. For individuals experiencing a single ACE type, we examine which ACEs are most strongly related to different health harms.

Authors: Mark Bellis, Karen Hughes+ 2 more
, Katie Cresswell, Kat Ford

Tackling Adverse Childhood Experiences (ACEs) State of the Art and Options for Action

This new report brings together what is known about ACEs across Europe and internationally, showing the on-going toxic impact that ACEs can have across the life course and how ACEs and their consequences can be prevented. The report supports the development of a trauma-informed society that is invested in action to prevent ACEs and better support those affected by them.

Authors: Sara Wood, Mark Bellis+ 3 more
, Karen Hughes, Zara Quigg, Nadia Butler

Associations between Adverse Childhood Experiences (ACEs) and Lifetime Experience of Car Crashes and Burns: A Cross-Sectional Study

Using a UK general population sample, this study has identified relationships between exposure to ACEs and lifetime experience of car crashes and burns; two major markers of unintentional injury. Findings highlight the need for effective interventions to prevent ACEs and reduce their impacts on health and well-being. A better understanding of the relationships between ACEs and unintentional injury, and the mechanisms that link childhood adversity to injury risks, can benefit the development of multifaceted approaches to injury prevention.

Authors: Kat Ford, Karen Hughes+ 3 more
, Katie Cresswell, Nel Griffith, Mark Bellis

What Works in the Prevention and Early Intervention of ACEs at the Community Level? Identifying and Supporting Projects across Wales

Previous research undertaken by ACE Hub Wales indicated that community projects across Wales provide support for community members in respect of a range of adversities. Building on this research, the aim of this project is to identify and map further community projects; to understand the most effective methods of supporting these projects as well as barriers to engagement; and finally to explore the impact of services on community groups

Authors: Samia Addis, Joanne C. Hopkins

Parental adverse childhood experiences and perpetration of child physical punishment in Wales

In 2022, Wales joined the growing number of countries to ban physical punishment of children in all settings. Using data collected a year prior to legislative change, this study explores relationships between Welsh parents’ exposure to ACEs whilst growing up and their use of physical punishment towards children.

Authors: Karen Hughes, Kat Ford+ 2 more
, Mark Bellis, Rebekah Amos

Adverse childhood experiences and their relationship with poor sexual health outcomes: results from four cross-sectional surveys

Improving understanding of risk factors for risky sexual behaviour is fundamental to achieve better population sexual health. This study explored associations between ACEs and poor sexual health outcomes in the UK. Findings highlight the need for effective interventions to prevent and ameliorate the lifelong effects of ACEs. Trauma-informed relationships and sex education, sexual health services, and antenatal/postnatal services, particularly for teenagers and young parents, could provide opportunities to prevent ACEs and support those affected.

Authors: Sara Wood, Kat Ford+ 4 more
, Hannah Madden, Catherine Sharp, Karen Hughes, Mark Bellis

What Works to Prevent Adverse Childhood Experiences (ACEs) at the Community Level? An Evidence Review and Mapping Exercise

Adverse Childhood Experiences (ACEs) are stressful experiences that occur during childhood which directly hurt a child (for example, maltreatment) or affect them through the environment in which they live (for example exposure to domestic violence). The aim of this project is to identify effective interventions at the community level relating to the prevention of ACEs and to identify initiatives undertaken across Wales.

Authors: Samia Addis, Troy Wey+ 2 more
, Ellie Toll, Joanne C. Hopkins

Maternal adverse childhood experiences and their association with preterm birth: secondary analysis of data from universal health visiting

Being born before full gestation can have short-term and life-long health implications, yet it remains difficult to determine the risk of preterm birth among expectant mothers. Across different health settings, increasing attention is given to the health and behavioural consequences of adverse childhood experiences (ACEs) such as child abuse or neglect, or exposure to harmful household environments (e.g. in which caregivers abuse alcohol), and the potential value of understanding these hidden harms when supporting individuals and families. A large international evidence base describes the association between childhood adversity and early years outcomes for mothers and children. However, the relationship between maternal ACEs and preterm birth has received far less attention.

Authors: Katie Hardcastle, Kat Ford+ 1 more
, Mark Bellis

Adverse childhood experiences (ACEs) in Bolton: Impacts on health, wellbeing and resilience

There is substantial evidence identifying the detrimental impacts that adverse childhood experiences (ACEs) can have on individuals’ health, wellbeing and broader life opportunities. A number of studies in the UK have identified the prevalence and impacts of ACEs at a national level, yet few studies have been undertaken at a local level. Understanding how local populations are affected by ACEs can enable local authorities and partnerships to tailor their support services, targeting resources to the health needs of the populations they serve. This study was implemented by Public Health Wales and Bangor University on behalf of Bolton Council to understand the impact of ACEs on the health and wellbeing of adults in the Bolton Local Authority area. The study explores:
■ The prevalence of ACEs in Bolton Local Authority;
■ Relationships between ACEs and health and wellbeing;
■ Resilience factors that may offer protection against the harmful impacts of ACEs.

Authors: Kat Ford, Karen Hughes+ 1 more
, Mark Bellis

Adult support during childhood: a retrospective study of trusted adult relationships, sources of personal adult support and their association with childhood resilience resources

Adverse childhood experiences (ACEs) can affect health and well-being across the life course. Resilience is an individual characteristic that is known to help negate the effect of adversities and potentially transform toxic stress into tolerable stress. Having access to a trusted adult during childhood is critical to helping children build resiliency. This paper aims to understand the relationship between always having access to trusted adult support and childhood resilience resources, and examine which sources of personal adult support and the number of sources of adult support, best foster childhood resilience.

Authors: Kathryn Ashton, Alisha Davies+ 4 more
, Karen Hughes, Kat Ford, Andrew Cotter-Roberts, Mark Bellis

Health Needs Assessment: COVID-19 and its impact on Children and Young People’s Experience of Violence and ACEs

This research, delivered by the Wales Violence Prevention Unit with funding from Public Health Wales, highlights how COVID-19 has resulted in many challenges for children and young people, including changes to routine, disruption to education and a reduction in access to support services and social activities. Evidence indicates that these challenges, together with other factors such as home life and existing wellbeing concerns, will likely have increased the risk of exposure to violence and adverse childhood experiences (ACEs), particularly among the most vulnerable children and young people.

Authors: Katie Cresswell, Emma Barton+ 3 more
, Lara Snowdon, Annemarie Newbury, Laura Cowley

Health visitor enquiry about caregivers’ adverse childhood experiences (ACEs): Key learning from a pilot evaluation

This report considers the feasibility and acceptability of ACE enquiry within routine health visiting contacts, from both the practitioner and service user perspective, and examines the impact of the implemented enquiry model on practitioner awareness and skills, the service user-practitioner relationship, and the health and wellbeing of families.

Authors: Katie Hardcastle, Mark Bellis

The annual costs of adverse childhood experiences (ACEs) in Wales

An infographic highlighting the annual costs of adverse childhood experiences (ACEs) in Wales. ACEs increase individuals’ risks of adopting health-harming behaviours and developing ill health. ACE survey data was used to calculate the proportion of key health risk behaviours and health conditions attributable to ACEs and estimate the associated annual costs to Wales.

Authors: Karen Hughes, Kat Ford+ 1 more
, Mark Bellis

Understanding the Impact of COVID-19 on Violence and ACEs Experienced by Children and Young People in Wales Interim Report

This report explores the impact of COVID-19 and the associated health protection measures on children and young people through a review of the available literature and analysis of multi-agency data. It captures the inequitable and long-term impact that the pandemic could have on children and young people, and highlights considerations for mitigating these negative consequences.

Authors: Annemarie Newbury, Emma Barton+ 2 more
, Lara Snowdon, Joanne C. Hopkins

Adverse childhood experiences during childhood and academic attainment at age 7 and 11 years: an electronic birth cohort study

Adverse childhood experiences (ACEs) have a negative impact on childhood health, but their impact on education outcomes is less well known. We investigated whether or not ACEs were associated with reduced educational attainment at age 7 and 11 years.

Authors: A. Evans, Katie Hardcastle+ 7 more
, A. Bandyopadhyay, D. Farewell, A. John, R.A. Lyons, Sara Long, Mark Bellis, S. Paranjothy

Adverse childhood experiences: a retrospective study to understand their impact on mental illness, self-harm and suicide attempt in a male Welsh prison population

Prisoners are at increased risk of poor mental health and self-harming behaviours, with suicide being the leading cause of death in custody. Adverse childhood experiences (ACEs) such as child maltreatment are strong predictors of poor mental health and wellbeing yet despite high levels of ACEs in offender populations, relatively few studies have explored the relationships between ACEs and prisoners’ mental health and wellbeing.

Authors: Kat Ford, Mark Bellis+ 3 more
, Karen Hughes, Emma Barton, Annemarie Newbury

Inspiration from ACE Interrupters in Great Britain

Sharing the stories of individuals who have made a remarkable difference to those affected by Adverse Childhood Experiences (ACEs).

Authors: Katie Hardcastle, Mark Bellis+ 4 more
, Kat Ford, Katy Hetherington, Joanne C. Hopkins, Emma Clark