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Adverse childhood experiences (ACEs) are correlated with later life mental health, substance abuse, health risk behaviors, and many serious health consequences, along with the associated high individual and societal costs.

The World Health Organization (WHO) has prioritized prevention of child maltreatment and supports addressing ACEs to improve public health as laid out in this 2009 meeting report. Providing recommendations for policymakers, this meeting report states: "To raise ACE awareness and bring these different sectors on board, a clear presentation that simply conveys the essence of the ACE concept, consequences and implications should be developed. Once this is available, participants would take every opportunity to deliver the presentation to their colleagues, peers and other potential interest groups" (p.9).

This website serves as a way to "link policymakers, program directors, practitioners, and researchers involved in the implementation and evaluation of ACE response strategies around the world" (p.10).

Thus, we hope to bring people together across sectors. While many policymakers, program directors, and practitioners recognize the relevance of ACEs to treatment and services in each of these areas, most human service agencies in the United States continue to operate as separate and distinct entities.

Discrete agencies provide substance abuse, mental health, health, homeless, and criminal justice services. People who are disadvantaged and experiencing multiple problems are challenged to navigate this fragmented service delivery system.

ACE research speaks to the need for professionals to work together and calls policymakers to transform our systems of care.

ACEs place a major economic burden on society.

  • Confirmed cases of child maltreatment in a single year are associated with an estimated total of $124 billion in lifetime financial costs, according to a Centers for Disease Control and Prevention (CDC) report (you can find the CDC's full report here).  
  • Intervention programs with disadvantaged children already demonstrate significant benefit-cost ratios with $5.70 for every dollar spent on a child by the time the child became an adult aged 27 and, when projected into the rest of their lives, $8.70 cost savings in crime reduction (see Schweinhart et al., 2011).
  • Each new developmental stage begins with the skills gained in the previous stage.
  • Costs of later investments are reduced by early investments in younger children.
  • Families, Schools, and other systems play a strong role in human capital development.

By integrating knowledge of effective helping approaches with ACE research, we can point to cost-savings associated with ACE prevention and intervention across the lifespan. Identification of policy examples supportive of ACE response will guide policymakers seeking to save money by supporting ACE response.

Program evaluation can further demonstrate how comprehensive "ACE-informed" programming, designed to mobilize resilience and recovery, serves to defray costly ACE consequences and prevent ACE transmission to the next generation.The SOAR approach can be applied for the ongoing evaluation of ACE-informed programming.

Tools and Resources for Policy Advocacy