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May 2018Vol. 19, No. 4Study Assesses Adverse Childhood Experiences and Strategies to Overcome Them

A recent Child & Adolescent Health Measurement Initiative study looks at the prevalence of adverse childhood experiences (ACEs) among children in the United States and strategies for families, caregivers, providers, and communities to help overcome them. The findings are based on data from the 2016 National Survey of Children's Health.

ACEs are negative childhood experiences that can cause social, emotional, behavioral, cognitive, and physical health problems across a lifespan and include the following:

  • Recurring or constant financial hardship
  • Divorce or separation of parent or guardian
  • Death of a parent or guardian
  • Incarceration of parent or guardian
  • Being a witness to violence in the home
  • Being a victim of violence or witnessing neighborhood violence
  • Living with anyone mentally ill, depressed, or suicidal
  • Living with anyone with a drug or alcohol problem
  • Being treated or judged unfairly as a result of race/ethnicity 

In 2016, nearly half of all U.S. children had experienced at least one of nine ACEs assessed in the study, and over 20 percent had experienced two or more. Key findings of the study include the following:

  • The rate of children with one or more of the nine ACEs assessed varied from 38.1 to 55.9 percent.
  • Most children with one ACE had at least one other, with rates ranging from 54.4 to 95.4 percent.
  • ACEs are prevalent for both publicly and privately insured children.
  • ACEs are common across all income groups, although 58 percent of U.S. children with ACEs live in homes with incomes less than 200 percent of the federal poverty level.
  • Black children are disproportionately affected by ACEs.

The study emphasizes that ACEs go beyond harming children and families to affecting entire communities and points to three factors that support the need for a population-wide, multisystem approach to ACEs in the United States:

  • High rates of ACEs for children and the adults who care for them
  • Similar risks to children's health and their engagement with school once ACEs occur
  • Intergenerational and downstream effects of ACEs (i.e., learning difficulties, mental health crises, declining school attendance, crime, incarceration, suicides) for children and the communities they live in

Despite the harmful impacts of ACEs, the study notes that resilience and supportive family relationships are protective and healing factors that can help children thrive in the face of adversity. On a broad scale, the study calls for stronger communities and neighborhoods and points to the important role of service providers, policy makers, and community leaders. It also looks to health-care providers, early childhood professionals, teachers, and home visitors to help teach the skills and tools that are essential for a healthy family environment.

A National and Across-State Profile on Adverse Childhood Experiences Among U.S. Children and Possibilities to Heal and Thrive is available at (1,480 KB).