In the 1980s, the American health care provider Kaiser Permanente was puzzled by high attrition rates in their obesity clinic in California. About half of the participants ended up dropping out of the programme in spite of the fact that they were losing weight. Curious to find out why the lead doctor of the programme designed a pilot test and found one common factor for respondents; they had all experienced childhood sexual abuse. The underlying cause of the weight gain was depression, anxiety and fear. The study evolved into path breaking research involving 17,000 participants looking at the prevalence 10 types of child trauma; physical, sexual, emotional, neglect, violence against mother, substance abuse, incarceration, mental illness and divorce. These 10 types of trauma came to be known as known as the Adverse Childhood Experiences (ACE).
The study revealed that childhood violence was in fact a major public health issue. The results were astounding 50 per cent of adults reported one ACE, 87 per cent reported two and 25 per cent reported two or more. Persons who had experienced 4 ACEs compared to someone who had none had a 4-12 fold increased health risks for alcoholism, drug abuse, depression and suicide. The number of categories of adverse childhood exposure showed a graded presence of adult disease including cancer, chronic lung disease, skeletal fractures and liver disease. ACEs was also strongly associated with adulthood high-risk health behaviours such as smoking, alcohol and drug abuse, promiscuity, and severe obesity, and correlated with ill-health.
In 2014, UNICEF published a global report on violence in childhood called Hidden in Plain Sight. The report highlighted the economic impacts of childhood violence. Children who are victims of violence are at higher risk of being absent from school or being suspended, dropping out of high school and college, getting lower grades, and having lower IQs. Children who experience multiple forms of violence also known as 'polyvictimization' are particularly vulnerable.
Childhood violence is also correlated with increased risk of falling into poverty, unemployment and face economic hardship as adults. Adults who had experienced childhood violence than those that had not were twice as likely to be unemployed and fall below the poverty line. Physical abuse was the most detrimental form of violence with victims have a 140 percent more chance of being unemployed. Victims of childhood sexual abuse were 80 per cent more likely to live below the poverty line and 90 per cent more likely to fall within the lowest income quartile. For women these results are exacerbated with longer lasting impacts; women in their 30s and 40 s earn less and having fewer assets than their peers who did not experience violence.
ChildLine an Indian NGO relies on a government study from 2007 to show that in India 69 per cent of children reported to have been physically abused. Of the children who were abused in family situations 88.6 per cent were abused by their parents. Every two out of three school children reported facing corporal punishment. In juvenile justice institutions 70.21 per cent of children in conflict with law and 52.86 per cent of children in need of care and protection reported having been physically abused. With regard to child labour 50.2 per cent of children work all seven days of the week. 81.16 per cent of the girl child labourers work in domestic households, while 84 per cent of the boy child labourers worked in tea stalls or kiosks. 65.99 per cent of boys and 67.92 per cent of girls living on the street reported being physically abused by their family members and other people. Girl child neglect was assessed girls comparing themselves to their brothers on factors like attention, food, recreation time, household work, taking care of siblings, etc. 70.57 per cent of girls reported having been neglected by family members. 48.4 per cent of girls wished they were boys. 27.33 per cent of girls reported getting less food then their brothers. Of the young adults (ages 18-24) interviewed, almost half of them reported having been physically or sexually abused as children.
Childhood violence in abhorrent and addressing it is a moral imperative. Emerging global research on the issues shows a clear link between childhood experiences and adulthood outcomes. We cannot separate childhood experiences and their consequences as they follow us into adulthood with complex and interconnected social, health and economic outcomes.
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BW Reporters
The author is Executive Editor of Public Policy at BW Businessworld
