The story of one of the biggest breakthroughs at the intersection of public health and clinical care began in the 1980s at an obesity clinic in San Diego. Dr. Vincent Felitti wanted to know why nearly half the patients in his program dropped out even though most of them reported successfully losing weight. He found that the majority of the nearly 300 people he interviewed had suffered sexual abuse as a child. As a result, he theorized that their weight gain may have been a coping mechanism for mental health illnesses resulting from unresolved childhood trauma. Later, he launched a landmark study at Kaiser identifying strong associations between health challenges in adulthood and childhood adversity.

Today, these are known as adverse childhood experiences (ACEs) which are potentially traumatic events or circumstances that occur during childhood and adolescence and are broadly grouped into three categories: abuse, neglect, and household dysfunction.