Prevalence of adverse childhood experiences (ACEs) among US children

• Published in: Child abuse & neglect Vol. 92; pp. 209 - 218
• Main Authors: Crouch, Elizabeth, Probst, Janice C., Radcliff, Elizabeth, Bennett, Kevin J., McKinney, Selina Hunt
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-06-2019; Elsevier Science Ltd
• Subjects: Adverse childhood experiences; African Americans; Age differences; Child maltreatment; Child poverty; Child welfare; Childhood experiences; Childhood factors; Children; Children & youth; Childrens health; Clinical outcomes; Divorce; Early intervention; Economic hardship; Family characteristics; Family structure; Health insurance; Health Needs; Health problems; Health services; Health status; Hispanic Americans; Marital disruption; National Surveys; Older children; Parent-child relations; Policy making; Polls & surveys; Poverty; Predictions; Public health; Rural areas; Rural communities; Special needs children; State Surveys; Trauma; United States > US; ACE; FPL; aOR; CI; SHCN; Child welfare; EPSDT; Trauma; NSCH; DRC; HOPE; Child maltreatment; Public health
• ISSN: 0145-2134; 1873-7757
• DOI: 10.1016/j.chiabu.2019.04.010

The purpose of this study was to estimate the prevalence of adverse childhood experiences (ACEs) among children in the United States and to examine the relationship between child and family characteristics and the likelihood of reported exposure to ACEs.
Data were drawn from the nationally representative 2016 National Survey of Children’s Health (NSCH). Parent-reported child ACE exposure was measured using counts of those reporting zero ACEs, one to three ACEs, and four or more ACEs.
The study sample included 45,287 children. The most prevalent types of ACE exposure experienced by children were economic hardship (22.5%) and parent or guardian divorce or separation (21.9%). Older children (34.7%), Non-Hispanic African American children (34.7%), children with special health care needs (SHCN; 36.3%), children living in poverty (37.2%), and children living in rural areas (30.5%) were more likely to be exposed to parental divorce or separation than their counterparts. Five cross-cutting factors emerged as important across outcomes: child’s age, family structure, poverty, type of health insurance, and SHCN status.
We found high prevalence rates of economic hardship on a national level. Our findings of higher prevalence among rural children further suggest the importance of the intersection of place and ACEs. Therefore, the geographic component of ACEs must be considered by policymakers. The identification of predictive factors related to high ACE exposure can inform early interventions at the national level.