Risk and Protective Factors

Key points

  • Many factors can increase or decrease the likelihood of someone experiencing or perpetrating violence.
  • Risk factors can increase the risk of experiencing or perpetrating violence and protective factors can reduce the risk.
  • Preventing adverse childhood experiences requires understanding and addressing risk and protective factors.

What are risk and protective factors?

Adverse childhood experiences (ACEs) are not often caused by a single factor. Instead, a combination of factors at the individual, relationship, community, and societal levels can increase or decrease the risk of violence.

Although some risk and protective factors are at the individual and family level, no child or individual is at fault for the ACEs they experience.

Risk factors are characteristics that may increase the likelihood of experiencing adverse childhood experiences. However, they may or may not be direct causes.

Protective factors are characteristics that may decrease the likelihood of experiencing adverse childhood experiences.

Please note the term “caregiver” will be used throughout to refer to parents and those who care for children but may not be biological parents.

Watch the Moving Forward video to learn more about how increasing what protects people from violence and reducing what puts people at risk for it benefits everyone.

Risk factors

Individual and family risk factors

  • Families experiencing caregiving challenges related to children with special needs (for example, disabilities, mental health issues, chronic physical illnesses).1
  • Children and youth who don't feel close to their parents/caregivers and feel like they can't talk to them about their feelings.2
  • Youth who start dating early or engaging in sexual activity early.3
  • Children and youth with few or no friends or with friends who engage in aggressive or delinquent behavior.4
  • Families with caregivers who have a limited understanding of children's needs or development.5
  • Families with caregivers who were abused or neglected as children.6
  • Families with young caregivers or single parents.7
  • Families with low income.8
  • Families with adults with low levels of education.9
  • Families experiencing high levels of parenting stress or economic stress.7
  • Families with caregivers who use spanking and other forms of corporal punishment for discipline.10
  • Families with inconsistent discipline and/or low levels of parental monitoring and supervision.11
  • Families that are isolated from and not connected to other people (extended family, friends, neighbors).12
  • Families with high conflict and negative communication styles.13

Community risk factors

  • Communities with high rates of violence and crime.5
  • Communities with high rates of poverty and limited educational and economic opportunities.14
  • Communities with high unemployment rates.15
  • Communities with easy access to drugs and alcohol.16
  • Communities where neighbors don't know or look out for each other and there is low community involvement among residents.17
  • Communities with few community activities for young people.18
  • Communities with unstable housing and where residents move frequently.19
  • Communities where families frequently experience food insecurity.20
  • Communities with high levels of social and environmental disorder.21

Protective factors

Individual and family protective factors

  • Families who create safe, stable, and nurturing relationships, meaning children have a consistent family life where they are safe, taken care of, and supported.2223
  • Children who have positive friendships and peer networks.242325
  • Children who do well in school.26272825
  • Children who have caring adults outside the family who serve as mentors or role models.2925
  • Families where caregivers can meet basic needs of food, shelter, and health services for children.2825
  • Families where caregivers have college degrees or higher.3031
  • Families where caregivers have steady employment.2831
  • Families with strong social support networks and positive relationships with the people around them.2427233225
  • Families where caregivers engage in parental monitoring, supervision, and consistent enforcement of rules.24273228
  • Families where caregivers/adults work through conflicts peacefully.273230
  • Families where caregivers help children work through problems.273230
  • Families that engage in fun, positive activities together.3230
  • Families that encourage the importance of school for children.28

Community protective factors

  • Communities where families have access to economic and financial help.33343536
  • Communities where families have access to medical care and mental health services.333536
  • Communities with access to safe, stable housing.333436
  • Communities where families have access to nurturing and safe childcare.3336
  • Communities where families have access to safe, engaging after school programs and activities.343536
  • Communities where families have access to high-quality preschool.36
  • Communities where adults have work opportunities with family-friendly policies.3536
  • Communities with strong partnerships between the community and business, health care, government, and other sectors.3536
  • Communities where residents feel connected to each other and are involved in the community.253536
  • Communities where violence is not tolerated or accepted.1436
  1. Crouch, E., Probst, J. C., Radcliff, E., Bennett, K. J., & McKinney, S. H. (2019). Prevalence of childhood experiences (ACES) among us children. Child Abuse & Neglect, 92, 209–218. https://doi.org/10.1016/j.chiabu.2019.04.010
  2. Priyam, P., & Nath, S. (2021). A cross-sectional study on the effect of adverse childhood events and perception toward parents on emotional intelligence. The Primary Care Companion For CNS Disorders, 23(5). https://doi.org/10.4088/pcc.20m02861
  3. Brown, M. J., Masho, S. W., Perera, R. A., Mezuk, B., & Cohen, S. A. (2015). Sex and sexual orientation disparities in adverse childhood experiences and early age at sexual debut in the United States: Results from a nationally representative sample. Child Abuse & Neglect, 46, 89–102. https://doi.org/10.1016/j.chiabu.2015.02.019
  4. Biglan, A., Van Ryzin, M. J., & Hawkins, J. D. (2017). Evolving a more nurturing society to prevent adverse childhood experiences. Academic Pediatrics, 17(7), S150–S157. https://doi.org/10.1016/j.acap.2017.04.002
  5. Wade, R., Shea, J. A., Rubin, D., & Wood, J. (2014). Adverse childhood experiences of low-income urban youth. Pediatrics, 134(1). https://doi.org/10.1542/peds.2013-2475
  6. Schickedanz, A., Halfon, N., Sastry, N., & Chung, P. J. (2018). Parents' adverse childhood experiences and their children's Behavioral Health Problems. Pediatrics, 142(2). https://doi.org/10.1542/peds.2018-0023
  7. Crouch, E., Radcliff, E., Brown, M., & Hung, P. (2019). Exploring the association between Parenting Stress and a child's exposure to adverse childhood experiences (aces). Children and Youth Services Review, 102, 186–192. https://doi.org/10.1016/j.childyouth.2019.05.019
  8. Giovanelli, A., & Reynolds, A. J. (2021). Adverse childhood experiences in a low-income black cohort: The importance of context. Preventive Medicine, 148. https://doi.org/10.1016/j.ypmed.2021.106557
  9. Hughes, K., Bellis, M. A., Hardcastle, K. A., Sethi, D., Butchart, A., Mikton, C., Jones, L., & Dunne, M. P. (2017). The effect of multiple adverse childhood experiences on health: A systematic review and meta-analysis. The Lancet Public Health, 2(8), e356–e366. https://doi.org/10.1016/s2468-2667(17)30118-4
  10. Afifi, T. O., Ford, D., Gershoff, E. T., Merrick, M., Grogan-Kaylor, A., Ports, K. A., MacMillan, H. L., Holden, G. W., Taylor, C. A., Lee, S. J., & Peters Bennett, R. (2017). Spanking and adult mental health impairment: The case for the designation of spanking as an adverse childhood experience. Child Abuse & Neglect, 71, 24–31. https://doi.org/10.1016/j.chiabu.2017.01.014
  11. Duke, N. N., Pettingell, S. L., McMorris, B. J., & Borowsky, I. W. (2010). Adolescent violence perpetration: Associations with multiple types of adverse childhood experiences. Pediatrics, 125(4). https://doi.org/10.1542/peds.2009-0597
  12. Calvano, C., Engelke, L., Di Bella, J. et al. Families in the COVID-19 pandemic: parental stress, parent mental health and the occurrence of adverse childhood experiences—results of a representative survey in Germany. Eur Child Adolesc Psychiatry (2021). https://doi.org/10.1007/s00787-021-01739-0
  13. Lackova Rebicova, M., Dankulincova Veselska, Z., Husarova, D. et al. Does family communication moderate the association between adverse childhood experiences and emotional and behavioural problems?. BMC Public Health 20, 1264 (2020). https://doi.org/10.1186/s12889-020-09350-9
  14. Larkin, H., Shields, J. J., & Anda, R. F. (2012). The health and social consequences of adverse childhood experiences (ACE) across the lifespan: An introduction to prevention and intervention in the community. Journal of Prevention & Intervention in the Community, 40(4), 263–270. https://doi.org/10.1080/10852352.2012.707439
  15. Manyema, M., & Richter, L. M. (2019). Adverse childhood experiences: Prevalence and associated factors among South African young adults. Heliyon, 5(12), e03003. https://doi.org/10.1016/j.heliyon.2019.e03003
  16. Dube, S. R., Miller, J. W., Brown, D. W., Giles, W. H., Felitti, V. J., Dong, M., & Anda, R. F. (2006). Adverse childhood experiences and the association with ever using alcohol and initiating alcohol use during adolescence. Journal of Adolescent Health, 38(4), 444.e1–444.e10. https://doi.org/10.1016/j.jadohealth.2005.06.006
  17. Khanijahani, A., Sualp, K. Adverse Childhood Experiences, Neighborhood Support, and Internalizing and Externalizing Mental Disorders among 6–17 years old US Children: Evidence from a Population-Based Study. Community Ment Health J 58, 166–178 (2022). https://doi.org/10.1007/s10597-021-00808-7
  18. Bledsoe, M., Captanian, A., & Somji, A. (2021). Special report from the CDC: Strengthening Social Connections to prevent suicide and adverse childhood experiences (aces): Actions and opportunities during the COVID-19 pandemic. Journal of Safety Research, 77, 328–333. https://doi.org/10.1016/j.jsr.2021.03.014
  19. Barnes, A.J., Gower, A.L., Sajady, M. et al. Health and adverse childhood experiences among homeless youth. BMC Pediatr 21, 164 (2021). https://doi.org/10.1186/s12887-021-02620-4
  20. Chilton, M., Knowles, M., Rabinowich, J., & Arnold, K. T. (2015). The relationship between childhood adversity and food insecurity: 'it's like a bird nesting in your head.' Public Health Nutrition, 18(14), 2643–2653. https://doi.org/10.1017/s1368980014003036
  21. Gentner, M. B., & Leppert, M. L. (2019). Environmental influences on Health and Development: Nutrition, substance exposure, and adverse childhood experiences. Developmental Medicine & Child Neurology, 61(9), 1008–1014. https://doi.org/10.1111/dmcn.14149
  22. Asmundson. (2019). ACEs : Using Evidence to Advance Research, Practice, Policy, and Intervention.
  23. Luther. (2019). Developing a More Culturally Appropriate Approach to Surveying Adverse Childhood Experiences Among Indigenous Peoples in Canada
  24. Guo, S., O'Connor, M., Mensah, F., Olsson, C. A., Goldfeld, S., Lacey, R. E., Slopen, N., Thurber, K. A., & Priest, N. (2021). Measuring Positive Childhood Experiences: Testing the structural and predictive validity of the Health Outcomes from Positive Experiences (HOPE) framework. Acad Pediatr. https://doi.org/10.1016/j.acap.2021.11.003
  25. Narayan, A. J., Rivera, L. M., Bernstein, R. E., Harris, W. W., & Lieberman, A. F. (2018). Positive childhood experiences predict less psychopathology and stress in pregnant women with childhood adversity: A pilot study of the benevolent childhood experiences (BCEs) scale. Child Abuse Negl, 78, 19-30. https://doi.org/10.1016/j.chiabu.2017.09.022
  26. Goetschius, L. G., McLoyd, V. C., Hein, T. C., Mitchell, C., Hyde, L. W., & Monk, C. S. (2021). School connectedness as a protective factor against childhood exposure to violence and social deprivation: A longitudinal study of adaptive and maladaptive outcomes. Dev Psychopathol, 1-16. https://doi.org/10.1017/S0954579421001140
  27. Bethell, C. D., Garner, A. S., Gombojav, N., Blackwell, C., Heller, L., & Mendelson, T. (2022). Social and Relational Health Risks and Common Mental Health Problems Among US Children: The Mitigating Role of Family Resilience and Connection to Promote Positive Socioemotional and School-Related Outcomes. Child Adolesc Psychiatr Clin N Am, 31(1), 45-70. https://doi.org/10.1016/j.chc.2021.08.001
  28. Liu, S. R., Kia-Keating, M., Nylund-Gibson, K., & Barnett, M. L. (2020). Co-occurring youth profiles of adverse childhood experiences and protective factors: Associations with health, resilience, and racial disparities. American journal of community psychology, 65(1-2), 173-186. https://onlinelibrary.wiley.com/doi/10.1002/ajcp.12387
  29. Bellis, M. A., Hughes, K., Ford, K., Madden, H. C. E., Glendinning, F., & Wood, S. (2022). Associations between adverse childhood experiences, attitudes towards COVID-19 restrictions and vaccine hesitancy: a cross-sectional study. BMJ Open, 12(2), e053915. https://doi.org/10.1136/bmjopen-2021-053915
  30. Nabors, L. A., Graves, M. L., Fiser, K. A., & Merianos, A. L. (2021). Family resilience and health among adolescents with asthma only, anxiety only, and comorbid asthma and anxiety. J Asthma, 58(12), 1599-1609. https://doi.org/10.1080/02770903.2020.1817939
  31. Merrick, M. T., Ford, D. C., Ports, K. A., & Guinn, A. S. (2018). Prevalence of Adverse Childhood Experiences From the 2011-2014 Behavioral Risk Factor Surveillance System in 23 States. JAMA Pediatr, 172(11), 1038-1044. https://doi.org/10.1001/jamapediatrics.2018.2537
  32. Bethell, C. D., Gombojav, N., & Whitaker, R. C. (2019). Family Resilience And Connection Promote Flourishing Among US Children, Even Amid Adversity. Health Aff (Millwood), 38(5), 729-737. https://doi.org/10.1377/hlthaff.2018.05425
  33. Sege, R. D., & Harper Browne, C. (2017). Responding to ACEs With HOPE: Health Outcomes From Positive Experiences. Acad Pediatr, 17(7S), S79-S85. https://doi.org/10.1016/j.acap.2017.03.007
  34. Liebenberg, L., Ungar, M., & LeBlanc, J. C. (2013). The CYRM-12: A brief measure of resilience. Canadian Journal of Public Health, 104(2). https://doi.org/10.1007/bf03405676
  35. Dietz, E. (2017). A New Framework for Addressing Adverse Childhood and Community Experiences: The Building Community Resilience Model.
  36. Benzies, K., & Mychasiuk, R. (2009). Fostering family resiliency: a review of the key protective factors. Child & Family Social Work, 14(1), 103-114. https://doi.org/10.1111/j.1365-2206.2008.00586.x