Adverse Childhood Experiences and Public Health

It is obvious that abuse and neglect can cause physical harm, from bruises and cuts to hemorrhage, broken bones, or death. Furthermore, long term physical and psychological effects may result from disabilities sustained from the injuries. As such, there has been significant research that supports how child maltreatment affects health in adulthood.

For example, in Ontario, a health survey found an association exists between childhood abuse and multiple health problems, poor or fair self-rated health, pain that interferes with activities, health-related disabilities, and frequent emergency room and specialist visits (but not general practitioner visits). Furthermore, the study suggests having a history of child abuse or neglect can lower overall physical immunity and the ability to manage stress (Pollak, 2007). Other studies have shown adults who experienced child abuse or neglect during childhood are more likely to suffer from physical ailments such as allergies, arthritis, asthma, bronchitis, high blood pressure, and ulcers (Springer, Sheridan, Kuo, & Carnes, 2007).

Emotional pain and suffering may also be a long term consequence. Besides the evident physical injuries that can be long lasting, stress can impair the unseen developing brain, causing certain regions to improperly form. Neurobiological research has found that stress effects brain chemistry, altering molecular structure in neurodevelopment. This alteration can result in poor physical, mental, and emotional development.

In normal development, stress is necessary because it helps children with new and potentially frightening situations. However these beneficial aspects fade away when the stress overwhelms the ability to cope. When this occurs, the nervous and immune systems can be compromised.
Prolonged exposure to cortisol can damage the brain’s hippocampus, and subsequently memory and cognition can be impaired (Middlebrooks, J.S., & Audage, N.C., 2008).

Feelings of fear from chronic abuse can result in startle response, hyperactivity, disturbed sleep, nightmares, and anxiety, which can cause a myriad of other problems. Emotional effects of maltreatment, such as an inability to trust can develop into low self-esteem, depression and relationship difficulty (Child Welfare Information Gateway, 2008). Because neurology and biology are associated within a person, a disturbance in one will likely cause a disturbance in the other.

For instance, studies have shown the association between childhood abuse and psychological disorders such as depression and withdrawal (Dubowitz, Papas, Black, & Starr, 2002), panic disorder, dissociative disorder, attention-deficit/hyperactivity disorder, posttraumatic stress disorder, and reactive attachment disorder (Teicher, 2000; De Bellis & Thomas, 2003; Springer, Sheridan, Kuo, & Carnes, 2007). Furthermore, a study of 700 foster care children found that more than one forth of them had a recurring physical or mental health problems (HHS, 2003). In addition to that, another study found that approximately 80 percent of young adults who had been abused met the diagnostic criteria for at least one psychiatric disorder (Silverman, Reinherz, & Giaconia, 1996).

Besides difficulty in physical and mental health, maltreated children tend to have difficulties in cognitive and linguistic development academic achievement and social skills (Zolotor, Kotch, Dufort, Winsor, & Catellier, 1999 & Schore, 2003). Furthermore, these children are likely to have behavioral problems in adolescence such as juvenile delinquency, high sexual risk behaviors, and alcohol and drug abuse (English, Widom, & Brandford, 2004, Johnson, Rew & Sternglanz, 2006, & Swan, 1998).

It doesn’t stop there, however. There are mounds of evidence that about one-third of maltreated children will eventually victimize their own children, or become victims of domestic violence (Prevent Child Abuse New York, 2003). Therefore the cycle of abuse can go on and on for generations.
Child Abuse & Public Health References – 1