Adverse Childhood Experiences Reported by Adults

Adverse Childhood Experiences (ACEs) have been linked to a wide range of health outcomes in adulthood including substance abuse, depression, cardiovascular disease, diabetes, cancer, and premature mortality.

Using the 2009 ACE module of the Behavioral Risk Factor Surveillance System (BRFSS) to examine whether a history of ACEs was common, 26,229 adults were interviewed in 5 states- Arkansas, Louisiana, New Mexico, Tennessee, and Washington. The MMWR report on ACEs among U.S. adults summarizes the results of that analysis. The module consisted of 11 questions that yielded 8 categories of ACEs (verbal abuse, physical abuse, sexual abuse, household mental illness, household substance abuse, domestic violence, parental separation/divorce and incarcerated family members). Respondents were asked to refer to the time period before they were 18 years of age when answering questions.

Overall, 59.4% of respondents reported having had at least one ACE while 8.7% reported five or more ACEs. Given the high prevalence of ACEs, additional efforts are needed at the state and local level to reduce and prevent childhood maltreatment and associated family dysfunction in the US, and further the development and dissemination of trauma-focused services to treat stress-related health outcomes associated with ACEs.

The most common ACEs were:

• Separated or divorced parents
• Verbal abuse
• Family member with depression or mental illness
• Witness of domestic violence
• Physical abuse
• Sexual abuse

Differences by gender

Men and women reported similar prevalence for having grown up with a mentally ill household member (22.0% for women, 16.7% for men) and growing up with a substance-abusing family member (30.6% for women, 27.5% for men). A difference between men and women was observed in the ACE category of sexual abuse, where women reported more than twice as many experiences as men (17.2% for women, 6.7% for men).

Differences by race/ethnicity

Black, non-Hispanic respondents had the lowest prevalence of each ACE category among all racial-ethnic groups. However, compared to all racial-ethnic groups Black non-Hispanics reported higher prevalence of having had an incarcerated family member (12.9%) and experiencing parental divorce (37.9%). Compared to Whites, Hispanics more frequently reported physical abuse (14.6% for Whites, 19.8% for Hispanics), witnessing domestic violence (15.1% for Whites, 21.7% for Hispanics), and having an incarcerated family member (6.2% for Whites, 9.5% for Hispanics).

These findings reinforce that adverse childhood experiences are common across racial/ethnic groups and states, further reinforcing the need to expand evidence-based child abuse prevention programs such as home visiting and parent education.

Data Source

CDC. Adverse Childhood Experiences Reported by Adults — Five States, 2009. MMWR 59(49);1609-1613.

More Information

• Academy on Violence and Abuse
• Adverse Childhood Experiences Study
• American Professional Society on the Abuse of Children
• American Psychological Association Trauma Psychology Division
• Childhood Maltreatment Prevention
• Legacy for Children™
• National Clearinghouse on Child Abuse and Neglect Information
• Preventing Child Maltreatment: Program Activities Guide