Evidence map›Paper›PMID 25174044›Full record

ArticleJournal of public health (Oxford, England)2015

Measuring mortality and the burden of adult disease associated with adverse childhood experiences in England: a national survey.

M A Bellis, K Hughes, N Leckenby, K A Hardcastle, C Perkins, H Lowey

Registry-linked trialOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of public health (Oxford, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05731557 (ACE, Resilience, and Substance Use Disorder), which is not on this map. Cited by 191 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
191citing papers in PubMed, 13 pooled it
13.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05731557 completednot on this mapstarted 2020, after this paper: background citation

ACE, Resilience, and Substance Use Disorder: Maternal and Baby Outcomes in the First Year of Life

TypeobservationalSponsorThe Cooper Health SystemRan2020 to 2024Enrolled120ConditionsAdverse Childhood Experiences
3 · Its place in the literature

Who cites it

191 citing papers in PubMed, 13 syntheses or guidelines pooled it, 393 citations in OpenAlex.

  1. Dimensions of early life adversity and cardiometabolic health in adulthood: A systematic review and meta-analysis.Health psychology : official journal of the Division of Health Psychology, American Psychological Association · 2026
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  11. Cumulative childhood adversity and adult cardiometabolic disease: A meta-analysis.Health psychology : official journal of the Division of Health Psychology, American Psychological Association · 2018
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131 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 1 country.

M A BellisCentre for Public Health, World Health Organization Collaborating Centre for Violence Prevention, Liverpool John Moores University, 15-21 Webster Street, Liverpool L3 2ET, UK Public Health Wales, Hadyn Ellis Building, Maindy Road, Cardiff CF24 4HQ, UK.
K HughesCentre for Public Health, World Health Organization Collaborating Centre for Violence Prevention, Liverpool John Moores University, 15-21 Webster Street, Liverpool L3 2ET, UK.
N LeckenbyCentre for Public Health, World Health Organization Collaborating Centre for Violence Prevention, Liverpool John Moores University, 15-21 Webster Street, Liverpool L3 2ET, UK.
K A HardcastleCentre for Public Health, World Health Organization Collaborating Centre for Violence Prevention, Liverpool John Moores University, 15-21 Webster Street, Liverpool L3 2ET, UK.
C PerkinsKnowledge and Intelligence Team (North West), Public Health England, 15-21 Webster Street, Liverpool L3 2ET, UK.
H LoweyBlackburn with Darwin Borough Council, Specialist Public Health Directorate, 10 Duke Street, Blackburn BB2 1DH, UK.
Liverpool John Moores University · GBBlackburn College · GBPublic Health England · GBPublic Health Wales · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundACE (adverse childhood experience) studies typically examine the links between childhood stressors and adult health harming behaviours. Using an enhanced ACE survey methodology, we examine impacts of ACEs on non-communicable diseases and incorporate a proxy measure of premature mortality in England.

methodsA nationally representative survey was undertaken (n = 3885, aged 18-69, April-July 2013). Socio-demographically controlled proportional hazards analyses examined the associations between the number of ACE categories (<18 years; e.g. child abuse and family dysfunction such as domestic violence) and cancer, diabetes, stroke, respiratory, liver/digestive and cardiovascular disease. Sibling (n = 6983) mortality was similarly analysed as a measure of premature mortality.

resultsOf the total, 46.4% of respondents reported ≥1 and 8.3% ≥4 ACEs. Disease development was strongly associated with increased ACEs (e.g. hazard ratios, HR, 0 versus ≥4 ACEs; cancer, 2.38 (1.48-3.83); diabetes, 2.99 (1.90-4.72); stroke, 5.79 (2.43-13.80, all P < 0.001). Individuals with ≥4 ACEs (versus no ACEs) had a 2.76 times higher rate of developing any disease before age 70 years. Adjusted HR for mortality was strongly linked to ACEs (≥4 versus 0 ACEs; HR, 1.97 (1.39-2.79), P < 0.001).

conclusionsRadically different life-course trajectories are associated with exposure to increased ACEs. Interventions to prevent ACEs are available but rarely implemented at scale. Treating the resulting health costs across the life course is unsustainable.

Indexed as

Cost of IllnessAdolescentAdultAdult Survivors of Child AbuseAdult Survivors of Child Adverse EventsAgedEnglandFemaleHealth SurveysHumansMaleMiddle AgedMortalityProportional Hazards ModelsRisk FactorsSurveys and Questionnaireschildrenchronic diseasemorbidity and mortality

Identifiers

PMID25174044
PMCPMC4552010
OpenAlexW2157407278

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.