Early childhood experiences have a profound impact on the way human beings develop. From core functions like talking and walking to more nuanced, emotional responses - what happens to us in our early years, quite literally changes our lives.
Adverse Childhood Experiences, also known as ACEs, are at epidemic proportions in Milwaukee, according to researchers at UWM. ACEs were first identified by researchers in an initial study by the Center for Disease Control and Kaiser Permanente, published in 1998.
"They identified five forms of abuse or neglect, and five forms of household dysfunction," says researcher Dr. Dimitri Topitzes. These forms of abuse and neglect include: physical, sexual and emotional abuse as well as physical and emotional neglect. The five types of household dysfunction included: divorce or separation of a parent, having an incarcerated family member, a family member struggling with substance abuse, a family member with mental-health related issues and family members facing intimate partner violence.
"These adverse experiences, including abuse and neglect, forecast poor health later in life."
Topitzes works with Dr. Joshua Mersky, and they're associate professors at the Helen Bader School of Social Welfare. They helped launch the Institute for Child and Family Well-Being, where they research the impact of ACEs and look for ways to solve these issues.
Their initial study on ACEs was comprehensive and helped to inform their secondary studies.
"Number one: [ACEs] occur at much higher rates than initially thought of. Number two: They tend to cluster, so that if somebody experiences one adverse childhood experience, the likelihood is that they're going to experiences two or more," says Topitzes. "And number three, and perhaps most importantly: These adverse experiences, including abuse and neglect, forecast poor health later in life."
"The greater the number of adversities to which I'm exposed, the more likely my health later in life is going to be compromised."
Topitzes says that "health" can mean many different things. "Something as basic as poor physical health - heart disease, cancer, cardio pulmonary obstructive disorder, etc. but we also mean something as nuanced as poor behavioral health, like alcoholism, or poor mental health, like depression or anxiety," he adds.
"The greater the number of adversities to which I'm exposed, the more likely my health later in life is going to be compromised," says Topitzes. He's quick to note that ACEs do not guarantee poor health later in life, and that these are really just probabilities.
Everyone responds differently to childhood trauma, he says; but the increased probability of poor health is a problem for a city like Milwaukee.
Topitzes says that in the city, "rates of exposure to adversity are nearly universal." In a study he conducted at community-based primary care clinics in Milwaukee, he found that "well over 90% acknowledged exposure to at least one adverse childhood experience."
"The vast majority of adults raised in high-crime, low-income neighborhoods of Milwaukee have been exposed to significant adversity."
"The vast majority of adults raised in high-crime, low-income neighborhoods of Milwaukee have been exposed to significant adversity," he continues. The fallout from this kind of exposure can be extreme. Studies have found that people with more ACEs have issues finding and keeping jobs and have much higher rates of addiction.
Mersky notes that the prevalence of ACE exposure in Milwaukee is probably not unusual. "There is no reason to believe that Milwaukee is in some way unique from many other urban centers," he explains.
Merksy and Topitzes are also working to fine solution and advocate for policy changes to address the issues ACEs cause. "One thing that we can do to address ACEs is to ask about them," says Mersky. "And there's been a long debate... in the literature about, 'Should we ask people about their adversity? Should we be asking them about their trauma?' And what the research will tell you is that there's a resounding 'Yes' to that question."
