Adverse Childhood Experiences
Description: The ACEs module of the Behavioral Risk Factors Surveillance System (BRFSS) asks respondents questions about eight different traumatic childhood experiences that occurred before the age of 18. These include verbal/emotional abuse, physical abuse, sexual abuse, and negative household situations including the incarceration of an adult, alcohol or drug abuse by an adult, violence between adults, mental illness of a household member, and parental divorce or separation. A cumulative ACEs score is calculated for each respondent by counting the number of these items that a respondent reported experiencing, creating a score ranging from 0 to 8.
Data Limitations: The ACEs module is a “lagging” indicator capturing childhood experiences retrospectively by asking adults 18+ years of age. Additional limitations include: 1) relies on self-reported information, 2) provides prevalence, not incidence data, 3) bias or measurement error associated with telephone-administered survey of a sample of the population (e.g., response bias, sampling variation), 4) designed to provide state-level population health estimates and does not provide sub-state estimates or estimates by racial sub-groups (e.g., Asian sub-groups) unless multiple years are combined.
Indicator Source: California Behavioral Risk Factor Surveillance System (BRFSS)
Indicator Calculation Methodology: 11 questions about ACEs are condensed into an ordinal scale from 0 to 8 possible ACEs. This indicator shows the prevalence of adults who reported having one or more ACEs. Other data cuts are also available, e.g., 3 or more ACEs.
Data Collection Methodology:
CDC BRFSS Data Documentation 2013;BRFSS User Guide June 2013; http://www.cdc.gov/brfss/data_documentation/index.htm
Program URL Link:
Geographic Granularity: State
Data categorized by:
Race/ethnicity: Hispanic (exclusive from other categories), White, Black or African American, Asian, Native Hawaiian or Other Pacific Islander*, American Indian or Alaskan Native*, MultiRacial. ( *Of note, annual estimates may be unstable due to small sample size.)
Sex: Male, Female
Health Payer: Medicare, limited data are available for health payer
Income level: Annual household income < $15,000, $15,000-24,999, $25,000-34,999, $35,000-49,999, $50,000+; other ranges are possible.
Age category: 18-24 years , 25-34 years, 35-44 years, 45-54 years, 55-64 years, 65+ years; other ranges are possible.
Other demographic: Education, employment status, marital status
Reporting Cycle: ACEs Module included in BRFSS every two years
Reporting Lag: BRFSS release frequency; ACEs module data analyses available 6-9 months after BRFSS data release
Indicator Source Changes: Because of the changes in the methodology, researchers are advised to avoid comparing data collected before the changes (up to 2010) with data collected from 2011 and onward: http://www.cdc.gov/brfss/annual_data/2013/pdf/compare_2013.pdf.
In addition, due to changes in the insurance variables, the “Other Public” insurance category was not able to be calculated in 2013
National Benchmark Source: (Not provided)
Tags (Keywords): Adverse Childhood Experiences, trauma, adversity