The ACE Index: mapping childhood adversity in England

Dan Lewer, Emma King, Glen Bramley, Suzanne Fitzpatrick, Morag Treanor, Nick Maguire, Miriam Bullock, Andrew Hayward, Al Story

Research output: Contribution to journalArticle

Abstract

Background

Studies of adults show that adverse childhood experiences (ACEs) are associated with health and social problems and are more common among people living in deprived areas. However, there is limited information about the geographical pattern of contemporary ACEs.

Methods

We used data from the police, social services, schools and vital statistics in England to calculate population rates of events that represent childhood adversity. We constructed an ‘ACE Index’ that summarizes the relative frequency of ACEs at local authority level, informed by the methods of the Index of Multiple Deprivation. We explored associations between the ACE Index and local characteristics in cross-sectional ecological analysis.

Results

The ACE Index was strongly associated with the proportion of children that live in income-deprived households (child poverty). In addition, the ACE Index was independently associated with higher population density and was higher in certain regions, particularly the north-east.

Conclusions

The association between ACEs and child poverty provides evidence of a process in which deprivation increases the risk of adverse experiences in childhood. The ACE Index can inform allocation of resources for prevention and mitigation of ACEs.
Original languageEnglish
JournalJournal of Public Health
DOIs
Publication statusPublished - 27 Dec 2019

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poverty
social problem
household income
index
population density
mitigation
resource
allocation
social service
analysis
method
police
school
rate
statistics
local authority
health

Cite this

Lewer, Dan ; King, Emma ; Bramley, Glen ; Fitzpatrick, Suzanne ; Treanor, Morag ; Maguire, Nick ; Bullock, Miriam ; Hayward, Andrew ; Story, Al. / The ACE Index: mapping childhood adversity in England. In: Journal of Public Health. 2019.
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The ACE Index: mapping childhood adversity in England. / Lewer, Dan; King, Emma; Bramley, Glen; Fitzpatrick, Suzanne; Treanor, Morag; Maguire, Nick; Bullock, Miriam; Hayward, Andrew; Story, Al.

In: Journal of Public Health, 27.12.2019.

Research output: Contribution to journalArticle

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AU - Lewer, Dan

AU - King, Emma

AU - Bramley, Glen

AU - Fitzpatrick, Suzanne

AU - Treanor, Morag

AU - Maguire, Nick

AU - Bullock, Miriam

AU - Hayward, Andrew

AU - Story, Al

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AB - BackgroundStudies of adults show that adverse childhood experiences (ACEs) are associated with health and social problems and are more common among people living in deprived areas. However, there is limited information about the geographical pattern of contemporary ACEs.MethodsWe used data from the police, social services, schools and vital statistics in England to calculate population rates of events that represent childhood adversity. We constructed an ‘ACE Index’ that summarizes the relative frequency of ACEs at local authority level, informed by the methods of the Index of Multiple Deprivation. We explored associations between the ACE Index and local characteristics in cross-sectional ecological analysis.ResultsThe ACE Index was strongly associated with the proportion of children that live in income-deprived households (child poverty). In addition, the ACE Index was independently associated with higher population density and was higher in certain regions, particularly the north-east.ConclusionsThe association between ACEs and child poverty provides evidence of a process in which deprivation increases the risk of adverse experiences in childhood. The ACE Index can inform allocation of resources for prevention and mitigation of ACEs.

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