May 2025 Board of Health Meeting - Addressing Adverse Childhood Experiences Information Report

PREPARED BY: Comprehensive Health Promotion

DATE: 2025-05-15

The early years of a child’s life are vital for their health and wellbeing, laying the groundwork for their future. Experiences in childhood, both positive and negative, significantly shape brain development and have lasting effects on a child’s physical and emotional health. Adverse childhood experiences (ACES) earlier on in a child’s life can disrupt these positive experiences, especially when there is a lack of support. ACES refer to stressful or traumatic experiences before age 18 that can cause an extreme or prolonged stress response. Early research identified key ACES, including physical, sexual, and emotional abuse, physical and emotional neglect, and household dysfunction (e.g., parental separation, witnessing domestic violence, substance use issues). Current research has also found that adversity can stem from other forms of trauma, including colonialism, racism, childhood poverty, lack of stable housing, and other individual and systemic forms of discrimination and inequity (Dawdy, J., Dunford, K. and Magalhaes Boateng, K., 2025).

The negative effects of ACES can be mitigated by enhancing protective factors that foster resilience.  Protective factors are characteristics and strategies that can help reduce the likelihood of children experiencing adversity and help create resiliency by focusing on the individual, family and the community. Some of these protective factors include:

• Families where caregivers have the ability and opportunity to create safe, stable, and nurturing relationships with their children and can meet the basic needs of food, shelter, and health services.
• Families with strong social support networks and positive relationships with the people around them.
• Children who have positive friendships/peer networks and adults outside the family who serve as mentors or role models.
• Communities where families have access to financial help, medical care and mental health services.
• Communities that provide access to safe, stable housing and where residents feel connected to each other and involved in the community.
• Communities where adults have work opportunities with family-friendly policies and where there are strong partnerships between the community and business, health care, government, and other sectors. 

DISCUSSION

Understanding ACES and the science of resilience offers public health a chance to intervene early with evidence-based strategies to mitigate and provide environmental support that can help reduce the impact of ACES. The WECHU can contribute by raising awareness about the effects of ACES and collaborating with the community on policy opportunities to ensure protective factors are in place to buffer adversity and foster resilience. 

Both international and national data indicate that 61.6% of the population has experienced at least one ACE. In Canada, a comprehensive 2018 study found that approximately 60% of individuals reported experiencing maltreatment (i.e., abuse and neglect that occurs to children) before age 15 (Public Health Ontario, 2025).  The 2020 Canadian Community Health Survey (CCHS) data for Windsor-Essex County reported that 19.3% of respondents had experienced at least one childhood maltreatment incident. Although ACES are common, there are significant disparities across populations. A recent meta-analysis revealed higher prevalence of 4+ ACES among certain groups, including Indigenous/Native Americans (40.8%), low-income households (40.5%), the unhoused (59.7%), individuals with mental health conditions (47.5%) or substance use issues (55.2%), and those with a history of criminality (31.8%) (Madigan, 2023). 

ADDRESSING ACES AND PROMOTING RESILIENCE IN WINDSOR-ESSEX COUNTY:

Preventing ACES has been proposed as an upstream intervention to reduce substance use, chronic diseases, mental health issues, improve overall health, and address health inequities faced by families. Several approaches have been identified to help reduce the impact of ACES in young children, focusing on three areas: building resiliency, adopting a trauma-informed approach, and creating positive/protective experiences. 

1. Building Resiliency: This involves fostering strong relationships with caregivers, developing children’s capacities and skills to handle trauma, and creating a protective community. Early childhood educators, health care providers, social services, and ACES experts play crucial roles, requiring strong partnerships across sectors (e.g., municipalities, healthcare, welfare services, police, and education). The Windsor Essex County Health Unit (WECHU) will collaborate with community organizations to implement policies and interventions aimed at preventing and mitigating ACES.
2. Trauma-Informed Approach: This strategy integrates knowledge about trauma into policies, procedures, and practices, actively seeking to resist re-traumatization. A system-level approach, including training on trauma-specific practices, and ongoing evaluation is essential. The WECHU will apply this method in its staff training and policy development, and share these practices with community partners such as targeting high priority schools to create more positive experiences for children.
3. Create Protective and Positive Experiences: This involves promoting positive parenting and communication, safety, trust, social support, a sense of belonging, and opportunities for success. The WECHU will implement a communication strategy to promote positive childhood experiences and address adversity (PACES) through education, awareness, and skill building approaches. 

By the end of 2025, the WECHU aims to achieve the following deliverables:

• Capacity building for staff across all departments (i.e., training and resources focusing on trauma-informed care and ACES).
• Policy recommendations to the WECHU Board of Health, with endorsed initiatives shared with community service and healthcare providers.
• Formation of a working committee with key community partners to explore community development strategies, identify barriers, and create a 2026 action plan using the social ecological model.
• A communication strategy introducing the concept of positive and adverse childhood experiences (PACES), including key messages about ACES, tips for parents and families to create positive experiences, and targeted messaging for vulnerable populations.  

Key References:

Dawdy, J., Dunford, K. and Magalhaes Boateng, K. (2025). Ontario Early Adversity and Resilience Framework. Public Health Ontario Adverse Childhood Experiences and Resilience Community of Practice

Madigan, S., (2023). Adverse childhood experiences: a meta-analysis of prevalence and moderators among half a million adults in 206 studies. World Psychiatry 2023; 22:463–471

Public Health Ontario (2022). Interventions to prevent and mitigate the impact of adverse childhood experiences (ACEs) in Canada: A literature review. Toronto, ON: Queen’s Printer for Ontario; 2020.