Resetting the relationship between local and national government. Read our Local Government White Paper

Adverse experiences in childhood

'ACEs Birmingham’ supports a multi-agency services approach to previous or current adverse experiences in childhood (ACEs),aiming to assist services to identify ACEs and enable individuals to overcome their impact.

View allChildren and young people articles

ACEs are linked to long-term impacts on an individual’s health, wellbeing and life chances. A growing body of research is revealing the extent to which experiences and events during childhood, such as abuse, neglect and dysfunctional home environments, are associated with the development of a wide range of harmful behaviours including smoking, harmful alcohol use, drug use, risky sexual behaviour, violence and crime. They are also linked to disease such as diabetes, mental illness, cancer and cardiovascular disease and ultimately to premature death.

The ten adverse childhood experiences include five direct ACEs:

  1. sexual abuse by parent/caregiver
  2. emotional abuse by parent/caregiver
  3. physical abuse by parent/caregiver
  4. emotional neglect by parent/caregiver
  5. physical neglect by parent/caregiver

and five indirect ACEs:

  1. parent/caregiver addicted to alcohol/other drugs
  2. witnessed abuse in the household
  3. family member in prison
  4. family member with a mental illness
  5. parent/caregiver disappeared through abandoning family/divorce.


The Birmingham Health and Wellbeing Board developed the ‘ACEs Birmingham’ approach as a response to the strength of evidence of a negative life course impact that untreated adverse childhood experiences can have for individuals. The health and wellbeing board initiated the ‘ACEs Birmingham’ approach drawing on the experience of West Midlands Police, which in turn, had taken learning from the South Wales Police Force:

‘Given the links of ACEs to an increased risk of violence and crime and associated high risk health behaviours, there is a clear alignment with policing and public health harm prevention priorities, with potential for early intervention work with the most vulnerable and at risk individuals and families.

Supported by a 2015 Home Office Innovation Fund, Public Health Wales and South Wales Police launched a public health approach to policing. The goal was to tackle the root causes of crime and help break generational cycles of adversity, developing systems over two years to analyse early indicators of harm, which will allow the police and other partners to identify those who may be particularly vulnerable.

Under the arrangement the Police and Crime Commissioner for South Wales, South Wales Police and Public Health Wales committed to sharing analysis and evaluation, developing an evidence-based approach to the prevention and reduction of ill-health and crime, and better targeting and evaluation to improve police and public health services provided to the public.’

Read the full case study

Adverse experiences in childhood