Preventable trauma in childhood costs North America and Europe $1.3 trillion a year

Public Health Wales Media Release

Across Europe and North America the long-term impact of Adverse Childhood Experiences (ACEs) on health and productivity is equivalent to 1.3 trillion dollars a year, according to a new paper published in the Lancet Public Health.

The cost is equivalent to a massive three per cent of the two regions’ combined Gross Domestic Product - or 1,000 dollars a year for every person in North America and Europe.

Adverse Childhood Experiences (ACEs) include being a victim of child maltreatment and being exposed to domestic violence, parental alcoholism and other severe forms of stress whilst growing up.

As many as 319 million people aged 15 or over in Europe and 172 million in North America are living with a potentially health-corroding legacy of ACEs, according to the paper.

In the first economic analysis of ACEs across North America and Europe this study examines how preventing ACEs across both regions would reduce pressure on health services from conditions including heart disease and cancer, as well as reducing the wider societal harms that arise from ACE related alcohol, drug use, anxiety and depression.

The paper, which is authored by the World Health Organization (WHO), Regional Office for Europe, Public Health Wales, and Bangor University, finds that ACEs are attributed to:

  • 18.2 per cent of individuals smoking in Europe, and 23.7 per cent in North America - at an estimated cost of $165 billion in Europe and $160 billion in North America
  • About 30 per cent of anxiety cases and 40 per cent of depression cases in North America, and more than a quarter of both conditions in Europe – at a combined annual cost of around $51 billion in Europe and $82 billion in North America
  • More than a quarter of cases of respiratory disease in North America and about one-fifth of cases in Europe – at an estimated cost of $99 billion in North America and $47 billion in Europe
  • Around 1 in 10 cancers in North America and Europe  - at an estimated cost of $95 billion in North America and $117 in Europe

Lead author of the paper, Professor Mark Bellis at Public Health Wales, said:

“Individuals who suffer ACEs such as child maltreatment or domestic violence can pay a high price through life-long impacts on their health and economic prospects. As a society, though, we all pay for failing to tackle childhood adversity through its impacts on our health services, social systems and work force.

“All children deserve a safe and nurturing childhood, and our findings provide economic support for this, indicating that even a moderate 10 per cent reduction in the numbers suffering ACEs could equate to annual savings of $105 billion per year.

“We know what needs to be done. Programmes to prevent ACEs and build resilience to reduce their impact on those still exposed are available.  Reducing the risks of childhood adversity requires investing in supporting families and children in their critical early years instead of spending far more later in life when many of the most costly consequences of childhood adversity materialise.”

Jonathon Passmore, World Health Organization, Regional Office for Europe, Programme Manager for Violence and Injury Prevention, said:

“Engagement with member states on Adverse Childhood Experiences remains a crucial objective for the World Health Organization in the European Region.  Quantification of ACEs and their consequences are key to the primary prevention of these experiences and, through a range of different interventions outlined in the INSPIRE technical package, are being prioritised in the region.”

The paper is a synthesis of multiple international studies on ACEs and economic analysis of their long-term impact on the health and productivity of victims as adults across Europe (WHO Region) and North America. The combined 23 studies draw data from 1.6 million individuals.

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Publication date: 4 September 2019