Researchers found that how you answer these inquiries about your childhood influences your health—so why aren't docs asking them?
You only see them once a year or when you're in a lot of pain, so it's no wonder you have a hard time talking to your doc. (And we won't even talk about the awkwardness of trying to ask your doc a question while wearing a glorified paper bag!) But that discomfort may go both ways, according to a new study that found doctors have a hard time asking difficult questions of their patients. And that could have a huge impact on your health. (Psst! Don't miss these 3 Doctor's Orders You Should Question.)
Researchers from the University of California, San Diego found that people's childhood experiences greatly influence their risk of heart disease, obesity, diabetes, mental illness, and other health problems. They came up with the Adverse Childhood Experiences (ACE) quiz which asked people 10 questions about child abuse, drug use, and domestic violence and assigned each person a score. The higher the score, the more likely the person was to suffer from a variety of health issues.
While the researchers were careful to say this test isn't a crystal ball for your health, they did find a strong enough correlation, suggesting that this quiz should be a part of every routine physical exam. So why isn't it already? "Some doctors think the ACE questions are too invasive," Vincent Felitti, M.D., one of the lead researchers on the project, told NPR. "They worry that asking such questions will lead to tears and relived trauma ... emotions and experiences that are hard to deal with in a typically time-crunched office visit."
The good news: These fears are largely unwarranted says Jeff Brenner, M.D., a MacArthur Fellows award winner and big proponent of the ACE. Most patients don't freak out, and the ACE score, Brenner explained, is "still really the best predictor we've found for health spending, health utilization; for smoking, alcoholism, substance abuse. It's a pretty remarkable set of activities that health care talks about all the time."
The message researchers want patients and doctors to take away: The type of home we grew up in—and the experiences we had as children—are important to our health, so we need to start having these conversations. Even just getting patients to think about their health today as it relates to childhood trauma is a step in the right direction. So at your next doctor's check-up, if your physician doesn't bring it up, perhaps you should.
Interested in your ACE score? Take the quiz:
1. Before your 18th birthday, did a parent or other adult in the household often or very often…
- swear at you, insult you, put you down, or humiliate you?
- act in a way that made you afraid that you might be physically hurt?
2. Before your 18th birthday, did a parent or other adult in the household often or very often…
- push, grab, slap, or throw something at you?
- ever hit you so hard that you had marks or were injured?
3. Before your 18th birthday, did an adult or person at least five years older than you ever…
- touch or fondle you or have you touch their body in a sexual way?
- attempt or actually have oral, anal, or vaginal intercourse with you?
4. Before your eighteenth birthday, did you often or very often feel that…
- no one in your family loved you or thought you were important or special?
- your family didn’t look out for each other, feel close to each other, or support each other?
5. Before your 18th birthday, did you often or very often feel that…
- you didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you?
- your parents were too drunk or high to take care of you or take you to the doctor if you needed it?
6. Before your 18th birthday, was a biological parent ever lost to you through divorce, abandonment, or other reason?
7. Before your 18th birthday, was your mother or stepmother:
- often or very often pushed, grabbed, slapped, or had something thrown at her?
- sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard?
- ever repeatedly hit over at least a few minutes or threatened with a gun or knife?
8. Before your 18th birthday, did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?
9. Before your 18th birthday, was a household member depressed or mentally ill, or did a household member attempt suicide?
10. Before your 18th birthday, did a household member go to prison?
For each time you answered "yes", give yourself one point. Add together for a total score ranging from zero to 10. The higher your score, the higher your health risks—but don't panic yet. The researchers add that the quiz is just a starting point; it doesn't take into account any therapy you've done or what positive childhood experiences you had. For more information on specific risks, visit the ACE study site.