The landmark 1998 ACEs study asked adults to recollect their history of these experiences and then compared their answers to their health status, as verified by a medical examination (Felitti, et al, 1998). The study observed that four or more ACEs before the age of 18 significantly increased the likelihood of poor adult outcomes in comparison to a history of no ACEs. For example, four or more ACEs were observed to more than double the risk of heart disease, quadruple the risk of lung disease and increase the risk of suicide by at least 12-fold in comparison to one or no ACEs.
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