“The victimization of children is nowhere forbidden; what is forbidden is to write about it.”
― Alice Miller, Thou Shalt Not Be Aware: Society’s Betrayal of the Child
In 1998, a large study commented on the health and social effects of adverse childhood experiences (ACE) over the course of a lifetime. It is an extremely significant report in that for the first-time researchers demonstrated the relationship between adverse conditions and experiences of childhood and how they would later affect the health and wellbeing of these children as adults. Three categories of adverse experiences were identified: childhood abuse, neglect and household challenges. Specific to the events taking place in Alabama, the abuse categories identified those adults studied later in life, who as children, were abused emotionally, physically and sexually.
The population was mostly white, college prepared, and approximately 50 years of age. The interviews indicated that these predatory incidents are well concealed by “time, shame, secrecy and social taboo.” The adverse experiences were predictors of how these victims went on to experience more disease, more alcoholism, more drug use, higher incidence of suicide attempts and early death.
As ACE increases so does the number of marriages, and unwanted pregnancies leading to abortion. Domestic violence increases by over 500 % and the likelihood of being raped by 900%. Adverse childhood experiences are responsible for half of all depression leading to suicide attempts, two thirds of rape cases, and 50% of domestic violence
With an ACE score going from 0 to 5, alcoholism increases 5-fold, intravenous drug use 9-fold and suicide attempts 17-fold. A rising ACE score is responsible for 2/3 of alcoholism, and half of all drug use. These risk factors associated with ACE underlie the 10 most common cause of death in the U.S.
It is no surprise then that these women are coming out now to reveal their terrible experiences. Physicians and public health professionals need to step up and give testimony to this fact of why women are revealing these negative experiences of their youth and doing so later in life. The reason for the timing of these revelations is based on multiple scientific studies since 1998. As the initial researchers at Kaiser Permanente and the CDC stated, individuals hide these feelings and this anger because of ‘time, secrecy, and social taboos.” These prominent figures that now have their political bully pulpit strike a nerve of courage in these women. The resiliency these women have developed to overcome these adverse conditions now allows them to speak up and be heard. We need to support them not only because of the credibility and corroboration of their stories but support them based on the science of what we now know about these experiences and how it affects their lives. We cannot assume for one moment that the sexual abuse inflicted upon a 14 year old by one political figure has been the only negative and harmful childhood experience. We are living in America, the land where not all benefit from a safe home, adequate education and housing , optimal health care and an adequate wage. Adverse Childhood Experiences are the most basic causes of health risk behaviors, morbidity, mortality, disability and health care costs in America. Yes, these experiences are very different from those experienced by an adult. The sooner we realize this the sooner we can make appropriate decisions about the Moore’s of the world, and hopefully someday, about health care in America.
Matt Masiello, M.D., MPH, FAAP
“The truth about our childhood is stored up in our body and lives in the depths of our souls, and although we can repress it, we can never alter it. Our intellect can be deceived, our feelings manipulated, and conceptions confused, and our body tricked with medication. But someday our body will present its bill, for it is as incorruptible as a child, who, still whole in spirit, will accept no compromises or excuses, and it will not stop tormenting us until we stop
evading the truth.”
― Alice Miller
Reference: Vincent J. Felitti, et al. Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death: The Adverse Childhood Experiences (ACE) Study. Amer J Prev Med 1998; 14(4).