Adverse Childhood Experiences and Health Outcomes: A 20-Year Real-World Study

Abstract

Adverse childhood experiences (ACEs) comprise several life events, including abuse (e.g., psychological, physical, sexual), neglect (psychological and physical), and household dysfunctions, among other violent situations that can happen in different settings. This ultimately leads to severe short- and long-term consequences for the children's health. The goal of this study is to analyze the prevalence of health outcomes in children <16 years of age, who were suspected of ACEs by physicians. The specific objectives consist of analyzing 3 health outcomes groups: (a) traumatic injuries and intoxications; (b) mental health disorders; and (c) physical disorders. We performed a real-world, retrospective, observational, cross-sectional, and multicentric study, using complementary data from electronic health records and healthcare registries from the local healthcare unit of Matosinhos, generated between January 1, 2001 and December 31, 2021 (total child population <16 years observed during that period=40 536). Keywords and ICD-9, ICD-10, and ICPC-2 codes were applied to find data on the victims. Just over 2% of children were identified as suspected victims (n=918). Social problems, injuries and intoxications, mental health disorders, and physical disorders were observed at higher percentages in suspected victims than in the total analyzed population. These results reveal that child victims of ACEs may be underdiagnosed, which, given the aforementioned (and described in the literature) severe consequences for their current and future health, should be taken as a critical warning for healthcare professionals. Detections and reports are fundamental for early treatment, aiming to avoid an escalation of damage and prevent re-victimization.