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Greek philosopher Aristotle’s maxim: ’Give me a child until he is 7 and I will show you the man’ is ringing down the ages as new research shows the estimated costs of adverse childhood experiences to the affected adults and to society across 28 European countries.

Adverse childhood experiences or ACEs include suffering maltreatment, witnessing violence in the home or community, and living with family difficulties such as parental substance abuse.  Exposure to such stressors is linked to poorer health and wellbeing across the life course, influencing children’s neurological, biological, and social development. It increases their susceptibility to social difficulties such as low educational attainment, health-harming behaviours such as smoking, and mental and physical illness. Although many people who suffer ACEs go on to live healthy, happy and productive lives, those that have experienced more ACEs are more likely to suffer ill health, achieve lower educational attainment and experience social deprivation.

All of these present major societal and economic costs. A new meta-analysis of available studies, published in The Lancet Public Health (Vol 6 November 2021 ) by public health researchers at 69��ý and Public Health Wales, provides stark evidence for policy makers across Europe to consider when setting priorities for post-COVID reconstruction. 

The new study estimates the cost of ACEs for each of 28 European countries, based on an analysis of the proliferation of recent research on the topic. In all the 28 European countries, ACE attributable costs exceeded 1% of national GDP, with the median proportion being 2·6%.

First author, Professor Karen Hughes of the WHO Collaborating Centre on Investment for Health and Well-being at Public Health Wales explained: 

“It is vital that the long-term economic costs of ACES are considered when countries emerge from the pandemic.

The pandemic may have increased children’s exposure to these stressors. Restrictions imposed to manage the pandemic have confined children and families within homes, closed essential social networks and support structures, and increased risk factors for ACEs such as unemployment and parental stress.”

Dr Kat Ford, Research Officer at the Public Health Collaborating Unit at the University’s School of Medical & Health Sciences said: 

“Our previous systematic reviews have examined the associations between ACEs and health outcomes and estimated the health and financial costs of ACEs at a continental level. This measured the financial costs of ACEs across ten health risks and causes of ill health were at  US$581 billion in Europe and $748 billion in North America; equivalent to 2·7% of Europe’s and 3·5% of North America’s regional gross domestic products (GDPs).”

Professor Mark Bellis of 69��ý and co-author of the work added:

“Those exposed to ACEs can also be at greater risk of exposing their own children to ACEs representing an intergenerational cycle of childhood adversity with on-going substantive costs to individuals and society.

ACEs and their consequences can be prevented however, and their costs avoided by investing in evidence-based early years support to families and in services that understand the needs of those affected by ACEs. 

As a result of the pandemic many aspects of the public sector are already under additional pressures. However for a sustainable future, it is critical that our plans for recovery prioritise investing in ACE-free childhoods that propel individuals on to healthy and prosperous life courses which will also leave them more physically and mentally resilient to future pandemics.”