Healthy Beginnings / Reducing Adverse Childhood Experiences

Reducing child trauma protects health throughout life

Adverse Childhood Experiences (ACEs) are traumatic events that occur before the age of 18, and includes  the number of survey participants experiencing at least  one type of adverse childhood experience. The Centers for Disease Control and Prevention’s ACEs study of more than 17,000 participants found that certain experiences are major risks for the leading causes of illness and death as well as poor quality of life in the United States. Some of the worst health and social problems in our nation can arise as a negative effect of ACEs.1

Indicator Progress

In 2008-2009 (baseline year), 59.0% of adults reported having Adverse Childhood Experiences before the age of 18. The most recent data available show 63.5% (2015). We hope to reach a target of 45.0% or lower by 2022.

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More Data

Baseline

59.0%

Current Rate

63.5%

Target

45.0%

Indicator Highlights

Four young kids smiling.

Bright Beginnings

Bright Beginnings is a program developed to create a healthy start for newborns and their mothers within the first 6-8 weeks after birth. The program focuses on breastfeeding support, early identification of maternal depression, interconception care and education. Participation in this program is available to all women who reside in Ventura County who give birth at participating hospitals, and the program hopes to expand to all birthing hospitals in the county in the future. Learn more »

Sixty percent of American children were exposed to violence, crime, or abuse in their homes, schools, and communities.1
In California, 61.7% of adults have experienced at least one ACE and one in six, or 16.7%, have experienced four or more ACEs.2
Child well-being in the U.S. has fallen to 26th out of 29 developed nations. An increasing number of children grow up with learning, behavioral and physical health challenges.3
Many studies suggest that changes which improve family, caregiver and neighborhood circumstances in the earliest years of a child’s life have the best chance of putting a child on a strong developmental path—emotionally, intellectually, and socially. And that’s a win for us all because those investments can yield a healthier, safer, better educated, more prosperous and more equitable nation.4

Data Snapshot: Trends & Disparities

ACEs also affect every community in California. In some counties, over 75% of residents have at least one ACE. Even in counties with the lowest prevalence of ACEs, 1 out of every 2 residents, or 50%, has one or more adverse experiences in childhood.3
A person with four or more ACEs is:

  • 21% more likely to be below 250% of the Federal Poverty Line (FPL)
  • 27% more likely to have less than a college degree
  • 39% more likely to be unemployed3

Proportion of Respondents Who Have Experienced at Least 1 Type of Adverse Childhood Experience, by Demographic Category

Download the Data Visualization Help

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Indicator: 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:
http://www.cdph.ca.gov/programs/sacb/Pages/default.aspx

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

1. U.S. Department of Justice . (2014, October 22). Facts about Children and Violence. Retrieved December 24, 2015, from justice.gov: http://www.justice.gov/defendingchildhood/facts-about-children-and-violence

2. Center for Youth Wellness. (n.d.). Findings on Adverse Childhood Experiences in California. Retrieved Decemner 24, 2015, from acestoohigh.files.wordpress.com: http://acestoohigh.files.wordpress.com/2014/11/hiddencrisis_report_1014.pdf

3. California Newsreel. (2015). The Raising of America. Retrieved December 24, 2015, from raisingofamerica.org: http://www.raisingofamerica.org/

4. California Department of Public Health. (2015, November 6). Essentials for Childhood Initiative: Safe, Stable, Nurturing Relationships and Environments. Retrieved Decmber 24, 2015, from cdph.ca.gov: http://www.cdph.ca.gov/programs/Pages/ChildMaltreatmentPrevention.aspx

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