Examining adverse childhood experiences (ACES) in a First Nations treatment-seeking population - Elaine Toombs (2020)

Experiencing adversity during childhood can disrupt typical childhood development and consequently affect health outcomes throughout the lifespan (Norman et al., 2012).  Ongoing research has identified that ten specific Adverse Childhood Experiences (ACES) have been associated with pervasive longitudinal health outcomes and the presence of chronic diseases such as cardiovascular disease and diabetes in adult populations. Although many of these relationships have been established within non-Indigenous populations, minimal research exists that has described similar outcomes for Indigenous populations.  Indigenous populations in Canada experience increased health disparities when compared to non-Indigenous populations, such as increased rates of mental health concerns, higher prevalence of some diseases and chronic health conditions, and overall have poorer access to social determinants of health that may help mitigate these concerns (Statistics Canada, 2018).  Life experiences related to childhood adversity experienced over time can also influence mental and physical health outcomes across generations. To better understand these relationships within Indigenous populations, the First Nations ACE study examined ACE scores in a First Nations population seeking substance use treatment, including participant-reported ACEs and health outcomes of parents and grandparents using a community-based participatory approach.  Regression models assessed the relationship among ACE scores and subsequent health outcomes reported by 141 individuals in an on-reserve residential treatment program.  Higher reported ACE scores were significantly associated with an increased number of health concerns, although odds ratios of increase rates of specific diseases were not significant.  Parent and grandparent ACEs and residential school attendance were not significantly related to increased health concerns by participants, although were associated with parenting difficulties.  Participants and staff involved with the First Nations ACE Study reported positive experiences with this research, and staff members reporting satisfaction with the CBPR practices embedded within the study.