Abused children more likely to be seriously ill as adults, says report

Children who suffer abuse, violence or other trauma at home are more likely to become seriously ill as adults, a report has concluded.

The study says children who endure four or more adverse childhood experiences (ACEs) are more than twice as likely to be diagnosed with a chronic disease in later life compared with those that have experienced none.

They are four times more likely to develop type 2 diabetes, three times more likely to develop heart disease and three times more likely to develop respiratory disease, according to the report from Public Health Wales.

According to the report, over a 12-month period, those with four or more ACEs were three times more likely to have attended accident and emergency units, three times more likely to have stayed overnight in hospital, and twice as likely to have visited their GP, again compared with people who report no ACEs.

The report, the first nationwide study of its kind produced by a public health body in the UK, argues that the reasons are not simply cyclical – that a child who has a challenging home life, where, for example, adults smoke or drink heavily, is more likely to do the same and suffer bad health as a consequence.

It points out there is growing evidence that in addition early life trauma leads to changes in neurological, immunological and hormonal development that have detrimental effects on health across a lifetime.

Children who are constantly exposed to stress can become permanently prepared to respond to further trauma – which can increase strain on the body.

ACEs are defined as traumatic experiences that occur before the age of 18, ranging from verbal, mental and physical abuse to exposure to alcoholism, drug use, domestic violence or parents’ relationships breaking down.

The lead report author, Prof Mark Bellis, the director of policy, research and international development at Public Health Wales, said its previous research had shown how ACEs increase the uptake of health-harming behaviours such as smoking and drug use and reduce mental wellbeing in adults.

He said: “This report shows how experiencing abuse and other problems in childhood are linked with increased levels of chronic disease in adulthood and much greater use of health care. What happens to us as children can make our bodies develop differently, leaving them more vulnerable to conditions like type 2 diabetes and heart disease in later life.”

Bellis said that finding solutions needed a change in approach.

“This cannot be achieved by the NHS alone. That is why we are working with our key partners, including the government, police, local authorities, charitable and voluntary sector organisations, to develop a joined-up approach to prevent ACEs and support adults whose health is suffering because of childhood trauma.”

The relationship between ACEs and the development of health-harming behaviours and chronic disease in adulthood was first explored in the US in the late 90s. The Centre for Public Health at Liverpool John Moores University – now the Public Health Institute – ran the first British study in Lancashire in 2012.

More than 2,000 adults aged 18-69 took part in the Welsh study, providing anonymous information on their exposure to ACEs before the age of 18 and their health and lifestyles as adults. The results take into account sociodemographic factors and show it is not simply the children of “deprived” homes who suffer ACEs.

Simon Capewell, vice-president of the Faculty of Public Health, said the Welsh study was very important. “This is the sort of data that needs to be used to prevent health issues that become a burden on the NHS and on our society,” he said.

Wales’s future generations commissioner, Sophie Howe, said the study showed public services had to work together. “This new evidence from Public Health Wales emphasises the importance of focusing on early years and reducing the number of children living in families where there is domestic abuse, mental health problems, substance misuse or other forms of abuse or neglect.

“If we don’t tackle this we are storing up long term health and social problems for these children and our public services further down the line.”

Abused children more likely to be seriously ill as adults, says report