A sociologist, a cardiovascular physiologist, and an immunologist walk into a bar…

April 28, 2026

Terrance J. Wade, PhD (Sociology)

Deborah D. O’Leary, PhD (Cardiovascular Physiology)

Adam MacNeil, Phd (Immunology)

Sorry, I can’t come up with a punchline. But I do have a story to tell about when sociologists talk to people in vastly different disciplines to better understand important social issues. I work in the Department of Health Sciences at Brock University. This department is essentially a microcosm of the university. I interact daily with people across disciplines ranging from humanities to physiology to bench science. 

In larger universities, we would never meet because we confine ourselves to our departments and these departments are usually located in different buildings and/or on different campuses. But meet we did, in the hallway, in the lunchroom, and in the pub. More importantly, we developed friendships and talked. We talked about all sorts of things, always coming back to our research. And we quickly realized we were all trying to answer similar questions. So here is our story.

As a sociologist, trained as a stress researcher, one of my longstanding research interests is on adverse childhood experiences (ACEs). For those of you not familiar with ACEs, it has been identified as one of the most important, yet hidden, public health issues of our time. ACEs are severe negative events occurring before the age of 18 and include experiences in the home like child abuse (i.e., physical, sexual, emotional), neglect (emotional, physical, economic), and household dysfunctions (i.e., witnessing intimate partner violence, having a family member with severe addictions and/or mental health problems, a parent in jail, separation from one or both parents), and other events outside the home (e.g., severe bullying, a natural disaster, witnessing a death, etc.). 

Most research generally focuses on ACEs in the home and several inventories have been developed and used globally to capture these home-based childhood exposures. Reported prevalence rates using these various inventories is about 60% of people reporting exposure to at least one ACE and about 20% to 25% reporting having been exposed to at least 4 ACEs (see Felitti et al 1998 for the landmark study; also see Afifi 2011; Madigan et al., 2023; Merrick et al., 2018). 

Moreover, ACEs have been found to be strongly associated with several negative outcomes including poor mental health, lifestyle behaviours, and chronic disease. And this association is not linear but exponential with higher exposure to ACEs leading to an accelerated increase in risk for disease. The question that I have been trying to answer is “how”. How are ACEs connected with all these outcomes? 

Now back to the pub. Initially, in 2007 I put together a grant with my cardiovascular physiologist colleague to examine the social determinants of blood pressure in children in a community sample, funded by the Heart and Stroke Foundation of Ontario. A novel study in its own right, doing detailed cardiovascular and heart health assessments involving Doppler ultrasound. So I slipped an ACEs inventory into the parent questionnaire. Obviously, as it was parents responding and these were kids in grades 6-8, we didn’t include most questions on maltreatment and household dysfunction. 

But even without these, we still saw a link between ACEs and their cardiovascular health (Pretty et al., 2013; Klassen et al., 2016). This piqued our interest for two reasons. First, that ACEs already appeared to be having an impact on young kids setting them on a potential lifelong trajectory of poor heart health and other chronic diseases (see Bellis et al. 2019). And second, we wanted to identify the mechanisms connecting ACEs and cardiovascular health. 

So now entering the pub was our recently hired immunologist, hired in time to be part of our discussions about a follow-up study ultimately funded in 2017 by CIHR (see Wade et al., 2019). With our Heart and Stroke participants now young adults, we were able to ask them directly about maltreatment and household dysfunctions and we proposed to examine the mechanisms behind this link. Importantly, they had rates of ACEs similar to national and international prevalence studies showing how endemic ACEs are in our communities. 

We repeated the same detailed cardiovascular measures and also took samples of blood (inflammatory markers), saliva (DNA), and scalp hair (chronic cortisol). While analyses are still ongoing, we have been able to start identifying various mechanistic pathways such as through the inflammatory system, to gain a fuller picture of these processes (e.g., Wong et al, 2022). Our findings linked ACEs with several pre-clinical markers of heart health that are connected to heart diseases in later adulthood (Rafiq et al., 2020). Additionally, we also saw that the cardiovascular system of those with a high ACE profile respond differently to externally imposed stress (in this case an orthostatic stress initiated via 60 degrees head up tilt at ) (Dempster et al., 2023). 

A Masters’ project we supervised simply examined blood serum in a pilot study. We compared males with a high ACE profile to males with a low ACE profile by exposing their serum to a commercially available line of male aortic endothelial cells. We saw higher gene expression of pro-inflammatory markers and lower gene expression of protective anti-inflammatory markers over a 24-hour period among those with a high ACE profile (Gagnon 2023; unpublished Masters’ thesis). We are now repeating this with a female aortic endothelial cell line and increasing our male sample as well.

While there is still much work to be done, there are two take-home messages from this story. First, it helps confirm that ACEs are much more prevalent than commonly perceived, and they are an enormous public health problem. About 1 in 4 people have high levels of exposure to ACEs exposing them to significantly greater risk for higher lifelong chronic CV and other diseases. So, now we need to understand the processes involved. 

Second, as a sociologist, this story shows the importance of moving outside one’s discipline to talk with others. To be able to better understand how social structure is connected to health outcomes provides a significant step forward in sociological health research. Moving beyond our usual inferences describing these connections to exploring the actual underlying mechanistic pathways would be impossible without these collaborations. And because we are all interested in the same question – how do we improve health - get out of your office and your department, go to the pub, and meet your new collaborators!

Key Readings:

Afifi 2011 Child Maltreatment in Canada: An Understudied Public Health Problem. Can J Public Health 2011;102(6):459-61.

Dempster KS, Wade TJ, MacNeil AJ, O’Leary DD. (2023) Adverse childhood experiences are associated with altered cardiovascular reactivity to head-up tilt in young adults. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology. DOI: 10.1152/ajpregu.00148.2022

*Felitti VJ, Anda RF, Nordenberg D, et al. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 1998;14(4):245-258. DOI: 10.1016/S0749-3797(98)00017-8.

Gagnon, M. (2023). The Effect of Adverse Childhood Events on Endothelial Function in Young Adults. Unpublished Masters’ thesis.

*Rafiq T, O’Leary DD, Dempster K, Cairney J, Wade TJ. (2020). Adverse childhood experiences (ACEs) predict increased arterial stiffness from childhood to early adulthood: Pilot Analysis of the Niagara Longitudinal Heart Study. Journal of Child & Adolescent Trauma, 13, 505-514. DOI: 10.1007/s40653-020-00311-3.

Klassen S, Chirico D, O’Leary DD, Cairney J, Wade TJ. (2016). Linking Systemic Arterial Stiffness among Adolescents to Adverse Childhood Experiences. Child Abuse & Neglect, 56, 1-10.

Madigan S, Deneault A-A, Racine N, Park J, Theimann R, Zhu J, Dimitropoulas G, Williamson T, Fearon P, Cénat JM, McDonald S, Devereux C, Neville RD. (2023). Adverse childhood experiences: a meta-analysis of prevalence and moderators among half a million adults in 206 studies. World Psychiatry 22:463-471.

Merrick MT, Ford DC, PhD; Ports KA, Guinn AS. (2018). Prevalence of Adverse Childhood Experiences From the 2011-2014 Behavioral Risk Factor Surveillance System in 23 States. JAMA Pediatrics. DOI:10.1001/jamapediatrics.2018.2537.

Pretty C, Cairney J, O’Leary DD, Wade TJ. (2013). Adverse childhood experiences and the cardiovascular health of children. BMC Pediatrics, BMC Pediatrics, 13:208. DOI: 10.1186/1471-2431-13-208.

Wade TJ, O’Leary DD, Dempster KS, MacNeil AJ, Molnar DS, McGrath J, Cairney J. (2019). Adverse childhood experiences (ACEs) and cardiovascular development from childhood to early adulthood: Study protocol of the Niagara Longitudinal Heart Study (NLHS). BMJ Open, 2019; 9: 7. DOI:10.1136/bmjopen-2019-030339.

Wong K, Wade TJ, Moore J, Marcellus A, Molnar DS, O’Leary DD, MacNeil AJ. (2022). Examining the relationships between adverse childhood experiences (ACEs), cortisol, and inflammation among young adults. Brain, Behavior & Immunology – Health. DOI: 10.1016/j.bbih.2022.100516