Tuesday, September 2, 2014

Adverse Childhood Experiences

What is an adverse childhood experience? Some of us refer to these experiences as youth risk. Read excerpts below and then go to the eleven-age brief, complete with tables. The number of Oklahoma youths with adverse childhood experiences is more ammunition for the need for mentors.

Thanks to the Oklahoma Institute for Child Advocacy (OICA) for sharing this.


Adverse childhood experiences (ACEs) are potentially traumatic events that can have 
negative, lasting effects on health and well-being.¹ These experiences range from physical, 
emotional, or sexual abuse to parental divorce or the incarceration of a parent or guardian. 
A growing body of research has sought to quantify the prevalence of adverse childhood 
experiences and illuminate their connection with negative behavioral and health outcomes, such as obesity, alcoholism, and depression, later in life. 

However, prior research has not reported on the prevalence of ACEs among children in a nationally representative, non-clinical sample.² In this brief, we describe the prevalence of one or more ACEs among children ages birth through 17, as reported by their parents, using nationally representative data from the 2011/12 National Survey of Children’s Health (NSCH). We estimate the prevalence of eight specific ACEs for the U.S., contrasting the prevalence of specific ACEs among the states and between children of different age groups. 

  • Economic hardship is the most common adverse childhood experience (ACE) reported nationally and in almost all states, followed by divorce or separation of a parent or guardian. Only in Iowa, Michigan, and Vermont is divorce or separation more common than economic hardship; in the District of Columbia, having been the victim of or witness to violence has the second-highest prevalence, after economic hardship.
  • The prevalence of ACEs increases with a child’s age (parents were asked whether their child had “ever” had the experience), except for economic hardship, reported about equally for children of all ages, reflecting high levels of poverty among young families.
  • Abuse of alcohol or drugs, exposure to neighborhood violence, and the occurrence of mental illness are among the most commonly-reported adverse childhood experiences in every state.
  • Just under half (46 percent) of children in the U.S. have experienced at least one ACE. In16 states, a slight majority of children have experienced at least one ACE. In Connecticut, Maryland, and New Jersey, 60 percent or more of children have never experienced an ACE.
  • States vary in the pattern of specific ACEs. Connecticut and New Jersey have some of the lowest prevalence rates nationally for all ACEs, while Oklahoma has consistently high prevalence.

We measured the prevalence of eight adverse childhood experiences (ACEs), consisting of whether the child ever: 

1. Lived with a parent or guardian who got divorced or separated; 

2. Lived with a parent or guardian who died;

3. Lived with a parent or guardian who served time in jail or prison;

4. Lived with anyone who was mentally ill or suicidal, or severely depressed for more than a couple of weeks;

5. Lived with anyone who had a problem with alcohol or drugs;

6. Witnessed a parent, guardian, or other adult in the household behaving violently toward another (e.g., slapping, hitting, kicking, punching, or beating each other up);

7. Was ever the victim of violence or witnessed any violence in his or her neighborhood; and

8. Experienced economic hardship “somewhat often” or “very often” (i.e., the family found it hard to cover costs of food and housing).

State-Level Variation in the Prevalence of Adverse Childhood Experiences 

Research has found that the highest levels of risk for negative outcomes are associated with 
having experienced multiple adverse childhood experiences (ACEs).³,⁴ Table 1 shows the number of ACEs parents reported for their child, by state. Nationally, a slight majority of children have not experienced any ACEs, but in 16 states more than half of children have experienced at least one ACE. In Montana and Oklahoma, 17 percent of children have experienced three or more ACEs. Some studies suggest that the experience of four or more ACES is a threshold above which there is a particularly higher risk of negative physical and mental health outcomes.⁵,⁶ Prevalence at this threshold is lowest in New Jersey and New York, at around three percent, and highest in OklahomaMontana, and West Virginia, at 10 to 12 percent (data not shown in Table). 

[Tables omitted in blog.]

Economic Hardship is the Most Common Adverse Childhood Experience

By far, the most common ACEs in all 50 states are economic hardship, and parental divorce or separation (Table 2). Nationally, just over one in four children ages birth through 17 has experienced economic hardship somewhat or very often. Only in Iowa, Michigan, and Vermont is divorce more prevalent than economic hardship (in Wyoming and Oklahoma they are equally prevalent). In most states (45), living with a parent who has an alcohol- or drug-use problem is the third-most-prevalent ACE (national prevalence is about one in ten children). Death of a parent is experienced by three percent of children nationally and is relatively rare in all states: only in the District of Columbia and Mississippi is prevalence greater than five percent (seven and six percent, respectively). 

The Prevalence of Specific Adverse Childhood Experiences Varies by Age (Except for Economic Hardship)

The prevalence of most ACEs naturally increases by age, since parents were asked whether their child had “ever” had the experience. As Table 3 shows, older children are more likely than younger children to have ever experienced each of the adverse childhood experiences, except for economic hardship, which is reported for 25 to 26 percent of children regardless of age. This reflects the high rates of poverty experienced by families with young children. 

Divorce is the second-most-common ACE experienced by children in each age group. About 
equal numbers of children ages birth to five have lived with someone who has an alcohol or 
drug problem, or have lived with someone with mental illness. Living with someone with an 
alcohol or drug-use problem is reported among 12 percent of 6- to 11-year-olds and 15 percent of 12- to 17-year-olds. One in seven 12- to 17-year-olds (14 percent) was the victim of, or witness to, neighborhood violence.

State-level rates for specific ACEs vary greatly for a given age group. For example, in the District of Columbia, 32 percent of 12- to 17-year-olds have experienced violence, compared with 14 percent nationally and 10 percent in Connecticut. In Mississippi, 15 percent of 12- to 17-year-olds, and nine percent of children under five, have witnessed domestic violence in their home, compared with national rates of ten and four percent, respectively. 

States in the Lowest and Highest Quartiles for Each Adverse Childhood Experience

Identifying which states fall into the highest and lowest quartiles of the distribution of prevalence 
rates provides another perspective on state-level variation. Although, as Table 3 shows, the states with the highest and lowest prevalence vary by ACE and by age group, some states stand out as having consistently high or low prevalence. 

Two states–Connecticut and New Jersey–have rates in the lowest quartile for all eight ACEs, whereas has rates in the highest quartile for all ACEs (see Table 4). Other states have consistently high or low prevalence, relatively speaking, across most, but not all, ACEs. For example, Virginia is in the lowest quartile for all ACEs, except for the death of a parent, for which prevalence falls around the national average. Michigan is among the states with the highest prevalence for three ACES: ever lived with someone with mental illness, ever had a parent in jail, and ever lived with a parent who divorced or separated. However, Michigan is also among the states with the lowest prevalence of having witnessed domestic violence, and around the national average for all other ACEs. Policymakers may benefit from taking a closer look at the prevalence of specific adverse experiences among the children in their own state. 

Potentially traumatic experiences are common among U.S. children, with more than one in four having been exposed to economic hardship, even in the first five years of life. One in five has experienced parental divorce or separation, and one in ten has lived in a household where an adult has an alcohol or drug problem. More troubling still, more than one in ten children nationally—and, in a few states, about one in six—has experienced three or more adverse experiences. These findings have important implications for children’s health and well-being, including the need for increased attention to the early detection and treatment of children affected by trauma, as well as to the conditions in families and communities that contribute to adverse development

Download the PDF for the brief at the link below.


Ret. 8-29-14

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