All About ACEs

All About ACEs (Adverse Childhood Experiences)

1. What are ACEs?

Adverse Childhood Experiences (ACEs) refer to a range of events or experiences that a child can experience, which can lead to stress and can result in trauma and chronic stress-based responses. Multiple, chronic, or persistent stress can impact a child’s developing brain, and numerous studies have linked stress to a variety of high-risk behaviors, chronic diseases, and negative behaviours and health outcomes in adulthood such as smoking, diabetes, and heart disease. For example, on a scale of 1-to-10 as used in scientific studies of ACEs, having an ACE score of 4 increases a person’s risk of emphysema or chronic bronchitis by 400% and suicide by 1200%.

2.  What is the “ACE Study”?

Published in 1998 as a collaboration between the Centers for Disease Control (CDC) and Kaiser Permanente (an American integrated managed care consortium, based in Oakland, California), the original ACE study was one of the first studies to look at the relationship between chronic stress in childhood and adult health outcomes. Data were collected during 1995-1997 from 17,000 Kaiser Permanente members who completed surveys on their childhood experiences and current health status and behaviors. Many states are now collecting state-specific ACE data through the Behavioral Risk Factor Surveillance System (BRFSS), an annual phone survey established by the CDC that collects data on health-related risk factors, chronic health conditions, and use of preventive services by U.S. adults. We’d like to do this in Bermuda because we can break the intergenerational cycle of trauma in our community.

Family Centre, along with the Bermuda Health Council, partnered to conduct research on ACEs in Bermuda, surveying adults who spent any part of their childhood in Bermuda.  The Bermuda Adverse Childhood Experiences – ACEs Study is first of its kind in Bermuda.

3.  What is the prevalence of ACEs?

ACEs are common and pervasive in the United States. In the original ACE study of adults, 64% of adults reported at least one ACE. More than one in five (or 20% of those surveyed) reported three or more ACEs and 12.4% reported four or more ACEs.

4.  What is the impact of ACEs?

The original ACEs study found a relationship between the numbers of ACEs and the number of high-risk behaviors and negative health outcomes across an adult’s lifespan. As the number of ACEs a person has increases, so does the risk for outcomes such as depression, smoking, obesity, heart disease, and cancer.

Click on the image to download the ACEs Medical Infographic

5.  What is the lasting impact of a high ACE score on behavior and health?

Simply put, our childhood experiences have a lifelong impact on our health and the quality of our lives. The ACE Study showed dramatic links between adverse childhood experiences and risky behavior, psychological issues, serious illness, and premature death.

6.  What is the Life Expectancy?

Of the people who were surveyed, those with six or more ACEs died nearly 20 years earlier on average than those without ACEs.

7.  What is the Economic Toll on Society?

The Centers for Disease Control and Prevention (CDC) estimates that the lifetime costs associated with childhood unresolved trauma at $124 billion in the US.

8.  What can Be Done About ACEs?

These wide-ranging health and social consequences underscore the importance of preventing ACEs before they happen. Safe, stable, and nurturing relationships and environments can have a positive impact on a broad range of health-related issues and on the development of skills that will help children reach their full potential. Strategies that address the needs of children and their families include, but are not limited to: maternal parenting, positive parenting and practices, the condition of the child’s home environment, and the child’s development.

Source: Fortson, B. L., Klevens, J., Merrick, M. T., Gilbert, L. K., & Alexander, S. P. (2016). Preventing child abuse and neglect: A technical package for policy, norm, and programmatic activities. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.

9.  How can I learn more about ACEs in Bermuda?

Article - click the links below to open each article in a new tabAuthorSourceDate
ACEs as missing link to chronic disease careStephanie Guthman PhD and Tara HinesThe Royal Gazette2021-01-28
World Children's Day: raising awareness on ACEsStephanie Guthman PhD and Tara HinesThe Royal Gazette2020-11-21
Family Centre Raises Awareness of 'ACEs'Family CentreBernews2020-11-19
World Children's Day: raising awareness on ACEsStephanie Guthman PhD and Tara HinesThe Royal Gazette2020-11-21
New normal still has to deal in AcesStephanie Guthman PhDThe Royal Gazette2020-07-23
Adverse child experiences costly in many waysMartha Harris MyronThe Royal Gazette2019-06-08
Childhood trauma conference plannedFiona McWhirterThe Royal Gazette2019-06-05
Holding all the Aces not always a winning handStephanie Guthman PhDThe Royal Gazette2019-04-06
Bermuda Health Council & Family Centre research on child trauma to be complete by JuneRenae StamppThe Royal Gazette2019-04-05
Bermuda Health Council backs Family Centre's study of childhood experiencesBermuda Health CouncilThe Royal Gazette2019-02-18
Why we should be concerned about ACEsStephanie Guthman PhDThe Royal Gazette2018-09-26
Video: Dr. Stephanie Guthman Speaks about Adverse Childhood Experiences at RotaryStephanie Guthman PhDBernews2018-07-24
  • Download these additional ACEs resources:
Download: ACEs-Zoom-Ad-Infographic-20210329.pdfDownload: BDA-ACEs-Study-Snapshot-Handout.pdfDownload: Bermuda-ACEs-Model.pdfDownload: BDA-ACEs-Take-Action-Handout.pdfDownload: Finding-your-ACEs-Scores-20210326.pdf
  • View the speaker presentations and other materials from Family Centre’s 2019 ACEs Conference.
    • Day 1: Understanding & Addressing Racial Trauma, presented in partnership with IAC and Citizens Uprooting Racism in Bermuda (CURB)
    • Day 2: The Economics of ACEs, presented in partnership with IAC

  • Watch the video:  ACEs Conference Bermuda Highlights from Day 1 – Understanding & Addressing Racial Trauma

Visit for resources on what you and your family can do to make a difference and help eliminate racial discrimination.

Family Centre Former Director of Training and Assessment, Dr. Stephanie Guthman at Bermuda ACES Conference 2018


Complex Trauma Resources: Tools for Survivors & their Helpers: A curated collection of Books, Videos, Articles and more to educate consumers, caregivers and professionals about Complex Trauma.  [Accessed April 30, 2019].

Reference: Centers for Disease Control and Prevention Adverse Childhood Experiences (ACEs) [Accessed April 16, 2019].

Family Centre, Department of Specialized Training & Assessment


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