Adverse Childhood Experiences (ACEs)


The first large-scale population study which linked Adverse Childhood Experiences, or ACEs, to poor adult health outcomes, published in 1998, was conducted by a partnership between the Centers for Disease Control and Prevention (CDC) and Kaiser Permanente. The study compared 10 categories of negative childhood experiences to a long list of poor health outcomes which includes heart disease, cancer, diabetes, and even depression. 

The study revealed that ACEs are incredibly common, 64% of the participants experienced at least 1 ACE. The study also discovered that the more ACEs a person had the higher their risk for health complications throughout life. 

The 10 ACE categories studied do not account for all possible types of childhood adversity.



  1. Physical
  2. Emotional
  3. Sexual


  1. Physical
  2. Emotional

HOUSEHOLD Challenges

  1. Parental divorce or separation
  2. Witnessing household violence
  3. Incarcerated household member
  4. Household substance abuse
  5. Household mental illness

Training and Helpful VISUALS


The Snohomish Health District regularly offers public screenings of the documentary Resilience: The Biology of Stress and the Science of Hope.

Request a screening by completing the online form.

  1. Toxic Stress
  2.  Resilience

How does childhood adversity lead to poor adult health outcomes? 

The evidence points to toxic levels of stress. Toxic stress occurs when a child experiences strong, frequent, and/or prolonged adversity in the absence of a safe, stable, and nurturing adult.

Toxic stress can disrupt or damage all of a child's developing systems. Disruption of brain development may lead to increases in learning difficulties, hyperactivity, or problems with memory and attention. Repeated or severe activation of stress hormones can increase levels of inflammation throughout the body which can then, over time, lead to damage to the heart and arteries. Toxic stress can even damage the immune system leading to a higher risk of infection or development of autoimmune diseases. 


Seeking additional support?

If you have Medicaid, try calling the Washington Mental Health Access Line at 888-693-7200.

For any other insurance carrier try calling the number on the back of the insurance card or log onto their website and search for provider coverage.