The NCSL Blog


By Kate Bradford

Adverse childhood experiences, or ACEs, are linked to 14 negative health and social outcomes in adulthood, such as depression, asthma, unemployment, and other issues, according to a new report from the Centers for Disease Control and Prevention (CDC).

CDC chart on ACEsThe report, published in CDC’s monthly Vital Signs, found that preventing ACEs has the potential to reduce leading causes of death such as respiratory and kidney disease, cancer and suicide.

Prevention can help children and adults thrive by lowering risks for certain costly health conditions, reducing risky behaviors such as smoking and heavy drinking, improving education and job potential, and preventing ACEs from being passed from one generation to the next.

What are ACEs?

Adverse childhood experiences encompass potentially traumatic events that occur before a person reaches the age of 18. Experiences such as violence, abuse, and growing up in a family with mental health or substance use problems can have lifelong implications for a person’s health, opportunities and stability.

 Toxic stress, or chronic stress sustained by a child over time without adequate adult support, can alter brain development and affect how the body responds to stress. Researchers have identified connections between ACEs and a greater likelihood of developing chronic health conditions, mental illness, substance misuse in adulthood, and reduced educational and occupational achievement. ACEs can even be cyclical.

CDC November Vital Signs Report

CDC scientists analyzed data from more than 144,000 adults in 25 states to create the new report. Among the report’s findings:

  • 1 in 6 adults have experienced four or more types of ACEs.
  • Women and several racial and ethnic groups are more likely to experience four or more ACEs.
  • Half of the top 10 leading causes of death are associated with ACEs.
  • Preventing ACEs could reduce the number of adults with heart disease by as much as 13%.
  • Preventing ACEs could reduce the number of adults with depression by as much as 44%.

Fortunately, there are certain protective factors that can help mitigate the long-term impacts of ACEs. Several efforts, including those by CDC, aim to better understand and even prevent ACEs. The CDC Vital Signs report highlights various ways everyone can help prevent ACEs.

Health providers can recognize children’s risk for ACEs and connect adults with family-centered treatment approaches. Efforts to strengthen families’ economic security may help reduce parental stress and protect children from experiencing abuse and neglect. Employers can support various family-friendly approaches, like paid family leave and flexible work schedules. Strategies that expand access to child care and education, and increase positive parenting skills can reinforce protective factors.

States and communities may consider policies that improve access to high-quality childcare, use effective social and economic supports and increase access to programs that enhance parents’ and youth skills to handle stress, resolve conflicts and manage emotions.

Learn more about ACEs and prevention strategies from the CDC Vital Signs report and the resources below.

Additional Resources

Kate Bradford is a research analyst for NCSL's Health Program.

Email Kate.

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This blog offers updates on the National Conference of State Legislatures' research and training, the latest on federalism and the state legislative institution, and posts about state legislators and legislative staff. The blog is edited by NCSL staff and written primarily by NCSL's experts on public policy and the state legislative institution.