Background Adverse childhood experiences (ACEs; i.e. child
maltreatment, household dysfunction) have wide-reaching
impacts and are strong predictors of poor outcomes in adults.
However, many individuals who experience ACEs avoid or
overcome their associated problems. The factors which effectively
promote resilience against ACEs are still largely
unknown.
Objective This research sought to understand what contributes
to an individual’s resilience and how much resilience offers
protection from the negative effects of ACEs.
Methods A face-to-face household survey was conducted with
2 497 residents aged 18–69 in Wales, United Kingdom, from
March-June 2017. The survey explored: exposure to 11
ACEs; access to childhood and adult resilience resources,
health-related behaviours and health outcomes.
Findings Half of all adults reported at least one ACE, 14%
had four or more. ACEs were strongly associated with worse
health outcomes, for example, individuals with 4+ACEs were
four times more likely to report current mental illness, six
times more likely to report lifetime mental illness and over
nine times more likely to have ever felt suicidal or selfharmed.
Childhood and adulthood resilience were associated
with better health outcomes in those both with and without
ACEs. Resilience resources associated with lower levels of
mental illness included, in childhood: sports participation and
having a trusted adult relationship; and as adults: sports/community
group participation, enjoying culture/traditions, financial
security, and higher perceived support from public services
and employers.
Conclusion and policy implications ACEs are common and represent
a significantly increased risk of poor health across the
life-course. Supporting individuals affected by childhood adversity
is vital to improve population health. Building resilience
can moderate the increased risk to health that ACEs pose.
However, resilience resources do not entirely counter ACErelated
harms, thus work should be directed at the prevention
of ACEs to ensure the provision of positive childhood environments
for future generations.