Objective Adverse childhood experiences (ACEs) are associated with poor health outcomes in adulthood. We developed ACE risk profiles using a domain-specific approach and examined ACEs as risk factors for diagnosed physical and mental health conditions.

Method A computer-assisted telephone survey was conducted with a random sample of adults in Alberta, Canada. Eight questions were asked on adversity during childhood, based on the original ACE survey and modified to reflect the Canadian context and research methodology. Descriptive and multivariable analyses were conducted.

Results Among the 1207 respondents, the majority were married or living common-law (65.8%), had completed post-secondary education (78.2%), and were Caucasian (86.2%) with a mean age of 52.4 years (SD=16.3). Approximately one-third (27.3%) experienced at least one type of abuse, and almost half (49.5%) experienced at least one form of household dysfunction. ACEs were highly interrelated. Sixty-three percent fell into the low risk profile, with the remaining 37% divided among the three higher risk profiles. Overall, ACE risk profile was significantly associated with diagnosed mental health condition/addiction and chronic pain, controlling for sociodemographic characteristics.

Conclusion The ACE risk profile of ACEs in both the abuse domain and the household dysfunction domain conferred the greatest risk for poor health outcomes in adulthood. Given the interrelated of ACEs, a more comprehensive approach to conceptualization of ACEs is warranted. Results have implications for prevention of ACEs and recovery from ACEs to decrease disease burden. Strategies may include effective programs to prevent exposure to toxic stress and support nurturing and stable relationships for children and families.