Social and Economic Factors

Health Impacts of Adverse Childhood Experiences

Over 600 children are evaluated at the Duke Child Abuse and Neglect Medical Evaluation Clinic each year.

Characterize risk factors and possible intervention points in electronic health records and state administrative data for children who experienced maltreatment.


  • Prevent child maltreatment in the health and social service systems through development of a provider alert system
  • Examine health outcomes for children who experience maltreatment
  • Develop biomarkers of ACEs to understand the biological mechanisms linking ACEs to poor health outcomes
  • Determine which treatment strategies are most effective after maltreatment has occurred

Biology of Adverse Childhood Experiences

ACEs have a profound impact on childhood and lifelong health; however, we do not understand the biological mechanisms that underlie the connection between ACEs and poor health outcomes.

Screen children and their parents for ACEs and social disparities during primary care encounters and take blood samples to develop biological markers of ACEs.


  • Elucidation of biological markers and mechanisms underlying health trajectories
  • Identify children who exhibit resilience in the face of ACEs and other social disparities to develop strategies to improve health and well-being outcomes for all children
  • Develop randomized controlled trials to test medical, behavioral, and environmental interventions to improve lifelong health and well-being
  • Improve population health

Translating Duke Health-CHDI Pilot Grant Awardee

Intergenerational Transmission of Resiliency to ACEs