ADVERSE CHILDHOOD EXPERIENCES Implications for Social Work Practice BY DR. NANCY ROSS, RSW
This brief article argues that the prevalence of adverse childhood experiences in Nova Scotia is an urgent public health ‘epidemic’ and signals a need for a paradigm shift in healthcare and community-based responses that can be defined and led by the profession of social work. Our team, funded by Research Nova Scotia, conducted the first adverse childhood experiences (ACEs) and resilience study in Nova Scotia within the Lunenburg Family Health Centre, and found that among the 226 patients who completed the survey 73 per cent reported one ACE and thirty one percent reporting four or more.1 These results differ significantly from ACE surveys in both the United States and Canada where typically the range of survey respondents reporting four or more adverse childhood experiences is between 13 per cent2 and 18 per cent3 and signifies the need for further research.
20 Connection | Winter 2021
The ACE questionnaire identified ten categories of childhood adversity including: physical, sexual and emotional abuse; physical and emotional neglect; and five measures of household dysfunction that included domestic violence; parental mental illness and/or substance abuse; an incarcerated relative and separation/divorce.2 Our research found that the four most commonly reported ACEs were living with someone who abused drugs and/or alcohol (39.8%, n =90); living with a household member with mental health challenges or attempted suicide (39.4%, n=89); parents separated or divorced (34.5%, n=78) and verbal abuse and afraid to be physically hurt (32.7%, n=74).1 Research has demonstrated that persons who experience one ACE are potentially at risk for long term health and social consequences and that there is a dose-response relationship where persons with total ACEs score of four or more are twice as likely to be smokers, seven times more likely to be alcoholic, have a 400 per cent increased risk of emphysema
