Toward Healing

What Happened to You?

Childhood trauma and how it impacts our emotional & physical health.

It’s time to change the conversation.

As a community, as a city, as a country, we can’t afford to keep hurting and inflicting, even more, pain on people who are already hurting. We need to begin to take the time to help hurt people move towards healing. It’s time to build a community of people who care enough about each other to stop asking, “what’s wrong with you?” and start asking:

“What happened to you?”

If we fail to address the root cause of the pain — our children, our families, our communities won’t get any better. Hurt people will continue hurting themselves and others.

Studies have shown that things that happen to us, especially as children, can have a long-term impact on our physical and emotional health. We call those the terrible things that happened to us as children, those things that we have difficulty overcoming, “adverse childhood experiences” or ACEs. This terminology came out of a huge public health study called the ACE Study. The original study was conducted from 1995 to 1997 by Kaiser Permanente and the CDC. It involved over 17,000 people, and it showed a direct link between the number/types of ACEs people report and the likelihood of negative physical and emotional health effects. The different categories of ACEs, identified in the original study (noted below in blue), conducted in primarily white suburban areas, as well as those identified and added in a later urban study (noted below in purple from The Urban ACEs Study conducted in Philadelphia) include:

Emotional abuse

Physical abuse

Sexual abuse

Physical neglect

Emotional neglect

Substance (drug/alcohol) abuse by a household member

Mentally ill household member

Parental separation or divorce

Incarcerated household member

Witnessing domestic violence

Witnessed violence

Felt discrimination

Unsafe neighborhood

Experienced bullying

Lived in foster care


Anyone reporting experiences falling into one of these categories would count it as one ACE. An experience from another category would count as an additional ACE. The more categories of ACES people have experienced, called their ACE score, the higher the likelihood that it will negatively impact their physical or emotional health.

For example, if someone reported having a parent incarcerated, being constantly bullied, and being a victim of sexual abuse, their ACE score would be three.  Whereas someone who hadn’t had experiences from any of these categories would have an ACE score of zero.

What both studies found is that ACES are very common. In the original study, more than half of the people who participated experienced at least one ACE. In the Philadelphia Urban ACE study, they found that an even higher, eight out of ten people have experienced at least one ACE. The higher an individual’s ACE score, the higher the liklihood of experiencing negative physical or emotional health outcomes. These negative health outcomes can show up in a number of ways including:

Alcohol abuse

Lung disease


Drug abuse

Heart disease

Liver disease

Kidney disease

Higher risk for domestic abuse

Sexually transmitted diseases


Suicide attempts



There hasn’t been an ACE study conducted in Baltimore, but the Child and Adolescent Health Measurement Initiative (CAHMI) found that nearly one-third of children in Baltimore City have two or more ACES. The categories were slightly different versus the original ACE study. They included extreme economic hardship, death of a parent, and racial discrimination but did not capture abuse or neglect. More info can be found about the work CAHMI is doing can be found here.

Want to learn more about ACES and how communities are using this tool to help in the healing process? Want to find out your ACE score? Here are some valuable links:

Understanding ACES

Get Your Ace Score

The Philadelphia Urban Ace Study

The Original Ace Study

The good news is, we are learning more and more about how the brain works and why ACES result in these negative health impacts.  Importantly, we are also learning more and more about how we can help others build up protective factors to help them  overcome ACES.

“The economic benefits of investing in children have been extensively documented. Investing fully in children today will ensure the well-being and productivity of future generations for decades to come. By contrast, the physical, emotional and intellectual impairment that poverty inflicts on children can mean a lifetime of suffering and want – and a legacy of poverty for the next generation… “

-- Carol Bellamy