People facing multiple hardships and victimization often have more severe symptoms and functional problems, including unhealthy coping strategies, lower performance at school or work, and relationship difficulties. Trauma worsens health disparities and strains limited resources. 

Adults with childhood adversity may struggle to create safe environments for themselves and their children, increasing the risk of their children facing similar challenges. 

People with trauma often seek help from various services. Research shows high rates of mental health and substance use disorders among those in the juvenile and criminal justice systems, many of whom have significant trauma histories. Children and families in the child welfare system also experience high levels of trauma. Young people often carry these experiences into schools, affecting their academic success. Additionally, many patients in primary care have trauma histories that impact their health and response to treatment. Organizations frequently employ staff at all levels who have experienced ACEs. 

Healthcare professionals and others who work with families play an important role in preventing ACEs and helping those affected. Clinical interventions commonly aim to address trauma and promote safe, stable, and nurturing relationships (SSNRs). However, many trauma survivors find these interventions are not enough. Improving agency conditions by fostering psychological safety—through the climate and circumstances in which services are delivered across systems—can be transformative for individuals, families, employees, and the wider community. 

ACEs also impact the workplace. Employees may bring personal struggles that affect their performance, including stress from trauma or difficult events. Negative workplace cultures or poor management can worsen this stress. This can lead to higher absenteeism and lower productivity, especially in fields like human services, where compassion fatigue is common. A trauma-informed approach can help reduce burnout and foster an environment where employees feel heard and valued.