Preventing Adverse Childhood Experiences

What are adverse childhood experiences?
Preventing Adverse Childhood Experiences

Adverse childhood experiences, or ACEs, are potentially traumatic events that occur in childhood (0-17 years). For example:

  • experiencing violence or abuse
  • witnessing violence in the home or community
  • having a family member attempt or die by suicide

Also included are aspects of the child’s environment that can undermine their sense of safety, stability, and bonding such as growing up in a household with:

  • substance misuse
  • mental health problems
  • instability due to parental separation or household members being in jail or prison

ACEs are linked to chronic health problems, mental illness, and substance misuse in adulthood. ACEs can also negatively impact education and job opportunities. However, ACEs can be prevented.

How big is the problem?

ACEs are common. About 61% of adults surveyed across 25 states reported that they had experienced at least one type of ACE, and nearly 1 in 6 reported they had experienced four or more types of ACEs.

Preventing ACEs could potentially reduce a large number of health conditions. For example, up to 1.9 million cases of heart disease and 21 million cases of depression could have been potentially avoided by preventing ACEs.

Some children are at greater risk than others. Women and several racial/ethnic minority groups were at greater risk for having experienced 4 or more types of ACEs.

ACEs are costly. The economic and social costs to families, communities, and society totals hundreds of billions of dollars each year.

What are the consequences?

ACEs can have lasting, negative effects on health, well-being, and opportunity. These experiences can increase the risks of injury, sexually transmitted infections, maternal and child health problems, teen pregnancy, involvement in sex trafficking, and a wide range of chronic diseases and leading causes of death such as cancer, diabetes, heart disease, and suicide.

ACEs and associated conditions, such as living in under-resourced or racially segregated neighborhoods, frequently moving, and experiencing food insecurity, can cause toxic stress (extended or prolonged stress). Toxic stress from ACEs can change brain development and affect such things as attention, decision-making, learning, and response to stress.

Children growing up with toxic stress may have difficulty forming healthy and stable relationships. They may also have unstable work histories as adults and struggle with finances, jobs, and depression throughout life. These effects can also be passed on to their own children. Some children may face further exposure to toxic stress from historical and ongoing traumas due to systemic racism or the impacts of poverty resulting from limited educational and economic opportunities.

How can we prevent adverse childhood experiences?

ACEs are preventable. Creating and sustaining safe, stable, nurturing relationships and environments for all children and families can prevent ACEs and help all children reach their full potential. CDC has produced a resource, Preventing Adverse Childhood Experiences (ACEs): Leveraging the Best Available Evidencepdf icon, to help states and communities take advantage of the best available evidence to prevent ACEs. It features six strategies from the CDC Technical Packages to Prevent Violence.

Preventing ACEs

Preventing ACEs

Strategy Approach
Strengthen economic supports to families
  • Strengthening household financial security
  • Family-friendly work policies
Promote social norms that protect against violence and adversity
  • Public education campaigns
  • Legislative approaches to reduce corporal punishment
  • Bystander approaches
  • Men and boys as allies in prevention
Ensure a strong start for children
  • Early childhood home visitation
  • High-quality child care
  • Preschool enrichment with family engagement
Teach skills
  • Social-emotional learning
  • Safe dating and healthy relationship skill programs
  • Parenting skills and family relationship approaches
Connect youth to caring adults and activities
  • Mentoring programs
  • After-school programs
Intervene to lessen immediate and long-term harms
  • Enhanced primary care
  • Victim-centered services
  • Treatment to lessen the harms of ACEs
  • Treatment to prevent problem behavior and future involvement in violence
  • Family-centered treatment for substance use disorders

Raising awareness of ACEs can help:

  • Change how people think about the causes of ACEs and who could help prevent them.
  • Shift the focus from individual responsibility to community solutions.
  • Reduce stigma around seeking help with parenting challenges or for substance misuse, depression, or suicidal thoughts.
  • Promote safe, stable, nurturing relationships and environments where children live, learn, and play.

Let’s help all children reach their full potential and create neighborhoods, communities, and a world in which every child can thrive.

See Adverse Childhood Experiences Resources for articles, publications, data sources, and prevention resources for Adverse Childhood Experiences.

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Page last reviewed: December 31, 2019