Adverse Childhood Experiences and Resilience

Adverse Childhood Experiences and Resilience

What are Adverse Childhood Experiences (ACEs)?

ACEs are difficult things that happen during childhood, in the home or in the community, that can cause trauma.

The following figure helps depict how those difficult things can occur across four realms – as adverse climate experiences, adverse childhood experiences, adverse community experiences, and atrocious cultural experiences. Adversity can also arise from experiences that are not explicitly noted in this graphic, like gender-based and disability-based trauma. With such a wide range of adverse experiences, we are all at risk for adversity.

Four realms of ACEs model: There are four realms of ACEs that can be shown in this image of a tree, its roots, the ground and water underneath and the sky above.
The tree indicates adverse childhood experiences, which can include: domestic violence, divorce, emotional and sexual abuse, maternal depression, physical and emotional neglect, substance abuse, incarceration, mental illness, and homelessness.
The roots indicate adverse community experiences, which can include: poverty and violence, poor housing quality and affordability, discrimination, lack of social capital, lack of economic mobility, and lack of opportunity.
The ground and water underneath the tree indicate atrocious cultural experiences, which can include: genocide, slavery, colonization, forced family separation, segregation, and harmful social norms.
The sky above the tree indicates adverse climate experiences, which can include: wildfires, droughts, floods, COVID-19, climate change, hurricanes, environmental injustice, and pollution.

Figure: “Four Realms of ACEs model” from The North Carolina Partnership for Children (NCPC)’s Building Healthy & Resilient Communities Across North Carolina: One Community at a Time report.

Why are ACEs important?

ACEs can increase the risk of negative, lasting effects on a person’s health and well-being. They can lead to toxic stress or weathering, which can disrupt organ, tissue, and brain development impacting physical health, mental health, social outcomes, and health risk behaviors.

ACEs are something many of us have experienced. The following infographic shows how common ACEs are in the US, within the Piedmont region, and in Durham alone.

ACEs are common: This infographic describes statistics related to ACEs at the national, regional, and county-levels.
Nationally, among adults surveyed across 25 states, about 3 in 5 adults surveyed reported they had experienced at least one type of ACE before age 18.
Regionally, in 2014, among adults surveyed in the Piedmont regions, over 1 in 5 adults reported they had experienced more than 2 ACEs.
County-wide, in 2019, among Durham residents, about 1 in 4 residents reported not getting the social and emotional support they need.

Where does resilience come in?

Resilience is our ability, as an individual, family, organization, or community, to bounce back from the impacts of trauma. We all have resilience, it’s how we continue to manage the stressors and difficult things in our lives.

Similar to ACEs, there are four realms of resilience: individual and interpersonal, community, environmental, and historical and cultural, as shown in the following figure. The figure also shows how there are many ways to be resilient.

Building resilience, though, is not a standalone solution to addressing ACEs. Work has to be done to actively prevent ACEs, so that individuals and communities don’t have to “bounce back” from difficult things and can be protected from traumatic experiences before they even occur.

Four realms of resilience: There are four realms of resilience that can be shown in this image of a tree, its roots, the ground and water underneath and the sky above.
The tree indicates the individual and interpersonal level, where resilience can look like: family support, problem-solving skills, nurturing caregiver, concrete support for basic needs, social connections, social emotional competence, knowledge of child development, adequate nutrition, exercise, mindfulness.
The roots indicate the community level, where resilience can look like: equitable economic development, living wages, safe parks and green spaces, civic engagement, trust in institutions and leadership, integrated and accessible healthcare services, coordination of resources and services, collective empowerment, and art and cultural expression.
The ground and water underneath the tree indicates the historical and cultural level, where resilience can look like: art and cultural expression, land acknowledgement, and commitment to human rights.
The sky above the tree indicates the environmental level, where resilience can look like: commitment to disaster preparedness, sustainable farming, conservation practices, emergency response plans, and equitable access to water.

Figure based on: The North Carolina Partnership for Children (NCPC)’s Building Healthy & Resilient Communities Across North Carolina: One Community at a Time report.

Additional Resources

To learn more about ACEs and resilience, check out the following resources:

At the national level:

CDC’s ACEs infographic

Positive & adverse childhood experiences (PACEs) Connection

At the state level:

Building Healthy and Resilient Communities Across North Carolina

Resilient NC: Supporting Statewide Efforts to Build Community Resilience – Executive Summary

At the community level:

Grown in Durham: Durham’s Early Childhood Action Plan (ECAP)

A Dreams Assessment: The Dreams of Black Parents, Black Students, and Teachers during COVID and Beyond

Durham Youth Listening Project

Next steps: How can we overcome the impact of ACEs?

ACEs do not determine any individual’s future and the impacts they may have are not inevitable. There are many ways we can address ACEs, including:

Encouraging positive childhood experiences, like safe, stable, and nurturing relationships and environments, which can outweigh experiences of adversity. Learn more about positive childhood experiences.

Being more trauma-informed, going beyond a single interaction or intervention and making systems-level changes in our organizations to provide better care to all individuals. Learn more about being trauma-informed.

Resilient Durham

Quick Links

Want to share a resource, event, or just chat about the work your organization is doing, with DART?

Email Bridget Nelson at bnelson@dconc.gov. Bridget is the Adverse Childhood Experiences and Resilience Coordinator at the Durham County Public Health Department.