Friday, October 25 is Dress Purple Day in Ontario. It’s an opportunity to reflect on the importance of child safety and well-being and the important role individuals and communities play in supporting vulnerable children, youth and families.
Children need access to the supports, resources and opportunities necessary for a healthy and nurturing environment. When they are not present, children are at a greater risk of adverse childhood experiences, also known as ACEs. ACEs are linked to poorer health in adult life, and they disproportionately impact equity-deserving groups, including racialized populations.
The term “adverse childhood experiences” describes traumatic or stressful experiences that can occur in childhood and adolescence. They can include physical, emotional or sexual abuse, or neglect. Neglect can be physical, like inadequate shelter, hygiene or clothing, or emotional, such as the absence of emotional or psychological support from caregivers. ACEs also include household challenges, such as exposure to mental illness, substance use or violence.
Types of ACEs
Source: Canadian Paediatric Society
While ACEs are often understood as individual experiences occurring within a family or a household, it is also important to consider adverse experiences that take place in neighbourhoods or communities, such as community violence.
Evidence shows the prevalence of ACEs in Ontario, as well as in British Columbia, Alberta, Manitoba and Quebec, is high.
Source: Canadian Longitudinal Study on Aging, analyzed by Joshi et al. (2021)
Minimizing the incidence and impact of ACEs is a critical health equity issue. This is of high importance given their significant role in creating and exacerbating negative health and social disparities.
ACEs cause “toxic stress,” changing the way the body responds and adapts to stress. This can have harmful impacts later in life. ACEs are linked to a myriad of poorer health and social outcomes, including cardiovascular disease, cancer and mental health and substance use issues. They are also linked to increased risk of exposure to violence and further victimization, homelessness and reduced education and employment opportunities.
A dose-response relationship exists between ACEs and their health and social consequences. This means that the more ACEs a person experiences, the greater their negative impact.
There are limited studies of ACEs and health in Ontario. Wellesley Institute is currently conducting research that aims to produce a detailed profile of ACEs in Ontario, including their impacts on physical and mental health, and differences in risk and impact by sociodemographic group. This research can be used to inform provincial-level early intervention and preventative approaches. We look forward to sharing this report in the new year.
We believe there could be important health and health equity gains to be made across society through increased attention to ACEs. Our health system and community services play a role in reducing the impact of ACEs on children and adults. But prioritizing upstream approaches that foster healthy and nurturing environments should be at the forefront of efforts to reduce the risk and health impact of ACEs for children and young people across their life course. It is easier to prevent problems, than to solve them.