Adverse Childhood Experiences (ACEs)

A child hugging a toy to his chest while sulking against a brick wall.

Adverse Childhood Experiences (ACEs)

Preventing early trauma to improve adult health

1 in 6 adults experienced four or more types of ACEs.
1 in 6 adults experienced four or more types of ACEs.
1 in 6 adults experienced four or more types of ACEs.

At least 5 of the top 10 leading causes of death are associated with ACEs.
At least 5 of the top 10 leading causes of death are associated with ACEs.

Preventing ACEs could reduce the number of adults with depression by as much as 44%.
Preventing ACEs could reduce the number of adults with depression by as much as 44%.
Preventing ACEs could reduce the number of adults with depression by as much as 44%.

Overview

Adverse Childhood Experiences (ACEs) are potentially traumatic events that occur in childhood. ACEs can include violence, abuse, and growing up in a family with mental health or substance use problems. Toxic stress from ACEs can change brain development and affect how the body responds to stress. ACEs are linked to chronic health problems, mental illness, and substance misuse in adulthood. However, ACEs can be prevented.

Preventing ACEs can help children and adults thrive and potentially:

  • Lower risk for conditions like depression, asthma, cancer, and diabetes in adulthood.
  • Reduce risky behaviors like smoking and heavy drinking.
  • Improve education and employment potential.
  • Stop ACEs from being passed from one generation to the next.

Preventing ACEs could reduce a large number of health conditions.

Preventing ACEs could reduce a large number of health conditions: UP TO 21 MILLION CASES OF DEPRESSION, UP TO 1.9 MILLION CASES OF HEART DISEASE, UP TO 2.5 MILLION CASES OF OVERWEIGHT/OBESITY

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SOURCE: National Estimates based on 2017 BRFSS; Vital Signs, MMWR November 2019.

Potential reduction of negative outcomes in adulthood

The graphic shows three tables on the potential reduction of negative outcomes in adulthood. The first table shows health conditions that could be reduced by the following amounts with adverse childhood experiences prevention: depressive disorder (44 percent), Chronic Obstructive Pulmonary Disease (27 percent), Asthma (24 percent), Kidney Disease (16 percent), Stroke (15 percent), Coronary Heart Disease (13 percent), Cancer (6 percent), Diabetes (6 percent), and Overweight/Obesity (2 percent). The second table shows health risk behaviors. The potential reduction of negative outcomes in adulthood for current smoking is 33 percent and heavy drinking is 24 percent. The third table shows socioeconomic challenges. The potential reduction of negative outcomes in adulthood for unemployment is 15 percent, earning less than a high school education is 5 percent, and not having health insurance is 4 percent.

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SOURCE: BRFSS 2015-2017, 25 states, CDC Vital Signs, November 2019.

Problem
Adverse Childhood Experiences impact lifelong health and opportunities.
ACEs are common and the effects can add up over time.
  • 61% of adults had at least one ACE and 16% had 4 or more types of ACEs.
  • Females and several racial/ethnic minority groups were at greater risk for experiencing 4 or more ACEs.
  • Many people do not realize that exposure to ACEs is associated with increased risk for health problems across the lifespan.
The Way Forward
Healthcare Providers Can:
  • Anticipate and recognize current risk for ACEs in children and history of ACEs in adults. Refer patients to effective services and support.
  • Link adults to family-centered treatment approaches that include substance abuse treatment and parenting interventions.
Employers Can:
  • Adopt and support family-friendly policies, such as paid family leave and flexible work schedules.
States and Communities Can:
  • Improve access to high-quality childcare by expanding eligibility, activities offered, and family involvement.
  • Use effective social and economic supports that address financial hardship and other conditions that put families at risk for ACEs.
  • Enhance connections to caring adults and increase parents’ and youth skills to manage emotions and conflicts using approaches in schools and other settings.
Everyone Can:
  • Recognize challenges that families face and offer support and encouragement to reduce stress.
  • Support community programs and policies that provide safe and healthy conditions for all children and families. http://go.usa.gov/xVvqD
Raising awareness about ACEs can help:
Two families sharing lunch together outdoors.
  • 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.
Issue Details

For More Information
1-800-CDC-INFO (232-4636)
TTY: 1-888-232-6348
Web: www.cdc.gov

Centers for Disease Control and Prevention
1600 Clifton Road NE
Atlanta, GA 30333
Publication date: November 5, 2019

Page last reviewed: November 5, 2019
Content source: Office of the Associate Director for Communication