ADVERSE CHILDHOOD EXPERIENCES
looking at how ACEs affect our lives & society
WHAT ARE ACES?
Adverse Childhood Experiences (ACEs) is the term given to describe all types of abuse,
neglect, and other traumatic experiences that occur to individuals under the age of 18.
The landmark Kaiser ACE Study examined the relationships between these experiences
during childhood and reduced health and well-being later in life.
FEMALE
WHO PARTICIPATED IN THE ACE STUDY?
GENDER
Between 1995 and 1997, over 17,000 people receiving physical exams completed
confidential surveys containing information about their childhood experiences and
current health status and behaviors. The information from these surveys was combined
with results from their physical exams to form the studys findings.
MALE
46%
OTHER
19-29
AFRICAN-AMERICAN
5%
30-39
10%
7%
ASIAN / PACIFIC ISLANDER
40-49
18%
5%
2%
RACE
54%
7%
AGE
19%
HISPANIC / LATINO
50-59
WHITE
60+
11%
75%
NOT HIGH SCHOOL GRADUATE
HIGH SCHOOL GRADUATE
EDUCATION
20%
46%
*Participants in this study reflected a cross-section of middle-class American adults.
SOME COLLEGE
36%
COLLEGE GRADUATE OR HIGHER
39%
HOW COMMON ARE ACES?
ZERO
36%
ONE
26%
TWO
16%
# of ACES
THREE
9.5%
FOUR OR MORE
12.5%
Almost two-thirds of adults surveyed reported at least one Adverse Childhood
Experience and the majority of respondents who reported at least one ACE
reported more than one.
TYPES of ACES
The ACE study looked at three categories of adverse experience: childhood abuse, which included emotional,
physical, and sexual abuse; neglect, including both physical and emotional neglect; and household challenges,
which included growing up in a household were there was substance abuse, mental illness, violent treatment of a
mother or stepmother, parental separation/divorce or had a member of the household go to prison. Respondents
were given an ACE score between 0 and 10 based on how many of these 10 types of adverse experience to which
they reported being exposed.
ABUSE
0%
25%
11%
50%
HOUSEHOLD CHALLENGES
75%
EMOTIONAL
0%
25%
50%
75%
MOTHER
TREATED VIOLENTLY
13%
27 % SUBSTANCE ABUSE
28 %
19%
PHYSICAL
SEXUAL
5%
0%
25%
15 %
50%
75%
EMOTIONAL
MENTAL ILLNESS
23% SEPARATION/DIVORCE
21%
NEGLECT
INCARCERATED
HOUSEHOLD MEMBER
10%
PHYSICAL
HOW DO ACES AFFECT OUR LIVES?
ACES CAN HAVE LASTING EFFECTS
ON
BEHAVIOR & HEALTH...
Simply put, our childhood experiences have a tremendous, lifelong impact on our health and the quality of our lives.
The ACE Study showed dramatic links between adverse childhood experiences and risky behavior, psychological issues,
serious illness and the leading causes of death.
The following charts compare how
likely a person with1, 2, 3, or 4 ACEs
will experience specified behaviors
than a person without ACEs.
*Having an ACE score of zero
does not imply an individual
could not have other risk factors
for these health behaviors/diseases.
PHYSICAL & MENTAL HEALTH
BEHAVIORS
SEVERE OBESITY
DIABETES
LACK OF PHYSICAL ACTIVITY
SMOKING
DEPRESSION
SUICIDE ATTEMPTS
ALCOHOLISM
DRUG USE
STDs
HEART DISEASE
MISSED WORK
CANCER
STROKE
COPD
BROKEN BONES
HOW DO ACES AFFECT OUR SOCIETY?
LIFE EXPECTANCY
People with six or more ACEs died nearly 20 years earlier on average than those without ACEs.
80
YEARS
60
6+
YEARS
ECONOMIC TOLL
The Centers for Disease Control and Prevention (CDC) estimates that the lifetime costs associated
with child maltreatment at $124 billion.
$83.5 BILLION
PRODUCTIVITY LOSS
$25 BILLION
HEALTH CARE
$4.6 BILLION
SPECIAL EDUCATION
$ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $
$ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $
$ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $
$ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $
$4.4 BILLION
CHILD WELFARE
$3.9 BILLION
CRIMINAL JUSTICE
$ $ $ $ $ $ $ $ $ $ $ $
$ $ $ $ $ $ $ $ $ $ $ $
$ $ $ $ $ $ $ $ $ $ $ $
$ $ $ $ $ $ $ $ $ $ $ $
FL, HI, ME, NC, NE, NV, OH, PA, UT, VT, WA, WI,
THE ACE STUDY CONTINUES
AR, CA, LA, NM, TN, WA
2009
DC, FL, HI, ME, NE, NV, OH, PA, UT, VT, WA, WI
2010
CA, ME, MN, MT, NE, NV, OR, VT, WA, WI
2011
CT, IA, NC, OK, TN, WI
2012
AK, CA, IL, IA, MI, OR, UT, WI
2013
AK, AR, FL, IA, KS, LA, NC, NV, OK, OR, PA, SC, TN, WI
2014
Although the study ended in 1997, some states are collecting information about
ACEs in their population through the Behavioral Risk Factor Surveillance System (BRFSS).
What can Be Done About ACES?
These wide-ranging health and social consequences underscore the importance of preventing ACEs before they happen. Safe, stable and nurturing
relationships and environments (SSNRs) can have a positive impact on a broad range of health problems and on the development of skills that will
help children reach their full potential. Strategies that address the needs of children and their families include:
Voluntary home visiting programs can help families by
strengthening maternal parenting practices, the quality of
the childs home environment, and childrens development.
Example: Nurse-Family Partnership
Home visiting to pregnant
women and families with
newborns
Parent support programs for
teens and teen pregnancy
prevention programs
Parenting training
programs
Mental illness and
substance abuse
treatment
Intimate partner violence
prevention
High quality
child care
Social support
for parents
Sufficient Income support
for lower income families
REFERENCES AND RESOURCES
REFERENCES
ACE Study
Child Welfare Information Gateway
Economic Cost of Child Abuse and Neglect
Essentials for Childhood
