Adding race to the ACE (Study)


Currently, in social service circles across the nation the Adverse Childhood Experiences (ACEs) study is becoming a focal point on understanding and treating clients. Dr. Vincent J. Felitti originally conducted the ACE study in 1985.

The original study was created from a weight-loss program for people with obesity. That study produced a result that showed that many of the participants unconsciously used their obesity as a shield against unwanted sexual attention, and many had been sexually or physically abused as children.

The study was reproduced in the 1990s with the addition of Dr. Robert F. Anda. This study examines both physical and emotional abuse, neglect, family dysfunction, and growing up in a household with someone who has chemical dependency or mental health issues. These were examples of toxic stress and traumatic experiences that can occur to individuals under the age of 18 years old, and how that relates to individuals’ health later in life. These childhood experiences highlighted decreased levels of health and well-being for individuals later in life depending on how prevalent such traumatic events were in their life.


Outcomes associated with adverse childhood experiences

The study used 10 basic questions about the individual’s childhood to determine risk level. If some answered yes to a question, they would be given a point. The points would add up to give the individual an ACE score. If someone scored a minimum of four, they would be considered high risk for serious health problems in the future.

The health problems often begin with the health-risk behaviors of smoking, overeating, drug use (street and legal), heavy alcohol use, and promiscuity. These behaviors in turn lead to disease, disability, and social problems in adulthood.

Resulting health issues include nicotine addiction, heart disease, cancer, stroke, diabetes, obesity, depression, unintentional pregnancy, chronic lung and liver disease, and sexually transmitted diseases. All these complications are ones in which the Black community ranks statistically high, if not first.

Two example questions are, “Did a parent or other adult in the household often or very often swear at you, insult you, put you down, humiliated you?” or did they “act in a way that made you afraid that you might be physically hurt?” Now, how many of us would answer yes to this question? I would.

If anyone has ever got a whupping from grandma, we would have at least one point. Another question is, “Did a household member go to prison?” Again, I would have another ACE point. How about the question, “Were your parents ever separated or divorced”? Yep, another point for me. Now, if the ACE score of 4 experiences leads to high risk of health disparities and problems, think about the average 8-12-year-old child who lives in North Minneapolis. What do you think his or her ACE score would be?


How does ACEs look  if you are Black?

Now, the majority of the study’s participants were White, college experienced, middle-class Americans. As we know, African Americans are on the top of the list for health problems such as hypertension, high blood pressure, diabetes, infant mortality, AIDS/HIV, obesity, etc. If you read the health section of this paper consistently, you would frequently read reports about various health problems we have in our community.

One must think, how do these disparities relate to the oppression and victimization we have faced in this society? It makes one wonder, are Black people born with Adverse Childhood Experiences just for being classified as Black?

I would suspect that a majority of Black people I know would score high on the ACE study. The trauma, which I often address in my articles, is a good reason for this. Both the historical and generational trauma that Black people are suffering from on a daily basis affects our health. Our emotional, behavioral, and physical health as a community is not where it can be. We are in a state of emergency. Thus, our lack of ability to deal with our pain constructively is not helping.


Where do we go from here?

When we step back and take a look at the Black community, you will see pain and trauma. This is an uncomfortable truth. It is not only our family in the “hood.” No, it is all of us across the board. Black professionals, Black organizations, Black agencies, and Black social groups are traumatized.

Let’s be honest and open about this fact. Then we can begin to heal from it. We are at a tipping point in time to take our community to the next level. If we miss this opportunity, our children may end up sliding further back than we are now.

I understand that some of us have made great strides of “success.” However, our community as a whole is struggling. In the words of the Honorable Malcolm X, “We need a self-help program.” The key word in that statement is “self.”

We, as a community, must help one another to heal. If we do not address our trauma, we will not get anywhere better than where we are now. If we are honest about our situation, we are not in a great place at the moment. In the words of KMOJ radio host Sam Simmons, “The village that hides the truth cannot expect to heal, but to pass on the pain.”


Brandon Jones M.A. is a Mental Health Practitioner. He welcomes reader responses to  or follow him on twitter @UniversalJones.