Consequences of Toxic Stress on the Body

Short Term

Boy Sitting in a Corner Covering His Face

The consequences of ACEs are not limited to chronic health conditions seen later in life. Health and behavioral outcomes in children experiencing adversity may manifest as developmental delay, failure to thrive, or sleep disruption in infants; asthma, learning difficulties, or behavioral problems in school-age children; and obesity, frequent headaches, or engaging in risky behavior as adolescents. If adversity is addressed early enough in life children have the opportunity to counter the negative effects of exposure to adversity by developing resilience and healthy coping mechanisms with the support of safe, stable, and nurturing relationships.

Long Term

Mother Hugging her Daughter


The evidence points to toxic levels of stress. Toxic stress occurs when a child experiences strong, frequent, and/or prolonged adversity in the absence of a safe, stable, and nurturing adult.

Toxic stress can disrupt or damage all of a child’s developing systems. Disruption of brain development may lead to increases in learning difficulties, hyperactivity, or problems with memory and attention. Repeated or severe activation of stress hormones can increase levels of inflammation throughout the body which can then, over time, lead to damage to the heart and arteries. Toxic stress can even damage the immune system leading to a higher risk of infection or development of autoimmune diseases.

The original ACE Study identified linkages between ACEs and several high-risk behaviors and poor health outcomes. The CDC currently recognizes over 40 behaviors and outcomes relating to ACEs in a dose-response relationship, meaning the more ACEs a person has the higher their risk for any number of poor health, behavior, or life potential indicators.

The high-risk behaviors and poor health outcomes that result from ACEs as identified in the ACE Study are:

  • Chronic obstructive pulmonary disease
  • Depression
  • Early initiation of sexual activity
  • Early initiation of smoking
  • Fetal death
  • Financial stress
  • Health-related quality of life
  • Illicit drug use
  • Ischemic heart disease
  • Liver disease
  • Multiple sexual partners
  • Poor work performance
  • Risk of intimate partner violence
  • Risk of sexual violence
  • Sexually transmitted diseases
  • Smoking
  • Suicide attempts
  • Unintended pregnancies


Harvard Center on the Developing Child: Toxic Stress Overview

TEDMED 2014: How Childhood Trauma Affects Health Across A Lifetime. By: Nadine Burke Harris



Those who have experienced 4 or more ACEs were 2.2 times more likely to smoke than someone with an ACE score of 0. They were also 7.4 times as likely to consider themselves an alcoholic, 4.7 times as likely to have used illicit drugs, 1.6 times as likely to have diabetes, 1.9 times as likely to have had cancer, and 12.2 times as likely to have attempted suicide.

ACEs in Snohomish County

2011: The effects of Adverse Childhood Experiences in Snohomish County (PDF)

2016: Trauma-informed Practices School Report: Snohomish County (PDF)