Creating ACE-informed places: promoting a whole-system approach to tackling adverse childhood experiences in local communities Association of Directors of Public Health

There is robust evidence linking adverse childhood experiences (ACEs) – such as physical or sexual abuse, domestic violence or parental separation – to severe negative health and social outcomes across people’s lives thereafter.

This project brought together key stakeholders across the system to explore and discuss the impact of ACEs and wider vulnerabilities, and to help facilitate learning and the sharing of good practice.

First, the team explored the evidence base, existing resources and work already underway in local areas. An advisory group was set up and interviews were held with 72 senior practitioners with experience of implementing trauma-informed practice – an approach that recognises that many of those who access a service may have experienced trauma that services do not routinely consider.

Four sector-specific resources were developed: for housing, policing, health and education. The resources and accompanying case studies explore the impact of trauma and adversity in early life, with the aim of supporting leaders and practitioners in implementing trauma-informed practice.

A sector-led improvement tool was developed to support areas to deliver a system-wide trauma-informed approach and to self-assess what it means to be trauma-informed.

A key challenge for the project was around framing and language. The focus on 10 ACEs, including physical, sexual and emotional abuse, risks excluding other factors associated with poor outcomes – for example, economic disadvantage, discrimination and poverty. The team held in-depth discussions with stakeholders to ensure that the resources take a nuanced view and recognise the limitations of just focusing on 10 ACEs.

Evidence suggests that childhood adversity has increased as a result of the pandemic, particularly in the most disadvantaged communities. The project team has developed a position statement which reflects on existing national policy and the impact of COVID-19, with the aim of contributing to the policy debate.

The materials were launched at a workshop in December 2021 and have been disseminated to Association of Directors of Public Health members and regional networks, and through social media.

Contact information

For more information about this project, please contact Lucy Sutton, Policy Manager at the Association of Directors of Public Health.