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Adverse Childhood Experiences Presentation Graphics

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Association Between ACEs and Negative Outcomes

Bar graph shows the relationship between ACEs and negative outcomes, as ACEs have been found to have a graded dose-response relationship with 40+ outcomes to date. The number of adverse childhood experiences from zero to five or more appear along the x-axis, and the risk for negative health and well-being outcomes is shown on the y-axis. Risk for negative outcomes increases greatly as number of ACEs increase. The pattern holds for the 40+ outcomes, but the risk values vary depending on the outcome.

ACEs can be Prevented

Infographic shows strategies and systems to create safe, stable, and nurturing relationships and environments important in preventing adverse childhood experiences. The first image is of a house. Above it reads “voluntary home visiting programs can help families by strengthening maternal parenting practices, the quality of the child’s home environment, and children’s development. Example: Nurse-Family Partnership.” Beside the image are the words, “home visiting to pregnant women and families with newborns.” Other images represent the following systems and strategies: Parent training programs, intimate partner violence prevention, social support for parents, parent support for teens and teen pregnancy prevention programs, mental illness and substance abuse treatment, high quality child care, and sufficient income support for lower income families.

The ACE Pyramid

Image shows a six-level pyramid to represent mechanisms by which adverse childhood experiences influence health and well-being throughout the lifespan. An arrow pointing upward is at the left of the pyramid. At bottom of the arrow is the word “conception;” at top is “death.” From the bottom up, the base of pyramid base of pyramid reads “Adverse Childhood Experiences.” Next level up reads “Disrupted Neurodevelopment.” Third level at middle of pyramid reads “Social, Emotional, and Cognitive Impairment.” Level four of the pyramid is Adoption of Health-risk Behaviors. Level five is Disease, Disability, and Social Problems. Level six at the top of the pyramid reads “Early Death.”

CDC-Kaiser Prevalence of ACEs

Prevalence of ACEs by Category for CDC-Kaiser ACE Study Participants, Waves 1 and 2. 

Types of ACEs. The ACE study looked at three categories of adverse experience: childhood abuse, which included emotional, physical, and sexual abuse; neglect, including both physical and emotional neglect; and household challenges, which included growing up in a household were there was substance abuse, mental illness, violence treatment of a mother or stepmother, parental separating/divorce or had a member of the household go to prison. Respondents were given and ACE score between 0 and10 based on how many of these 10 types of adverse experience to which they reported being exposed. The first graph shows abuse. 11% of respondents reported emotional abuse; 28% reported physical abuse; and 21% reported sexual abuse. The second graph shows household challenges. 13% of respondents reported violent treatment by their mothers; 27% reported substance abuse; 19% reported mental illness; 23% reported parental separation or divorce; and 5% reported incarceration of a household member. The third chart shows neglect. 15% reported emotional neglect, and 10% reported physical neglect.

Note: Research papers that use Wave 1 and/or Wave 2 data may contain slightly different prevalence estimates.

How Common are ACEs

ACE Score Prevalence for CDC-Kaiser ACE Study Participants, Waves 1 and 2.

Pie chart shows the prevalence of adverse childhood experiences by category among the entire CDC-Kaiser ACE study of 17,337 participants. At the top of the chart reads How Common Are ACES? 36% of the participants reported zero adverse childhood experiences; 26% reported one; 16% reported two; 9.5% reported three; 12.5% reported four or more adverse childhood experiences. Almost two-thirds of adults surveyed reported at least one adverse childhood experience, and the majority of respondents who reported at least one ACE reported more than one.

Note: Research papers that use Wave 1 and/or Wave 2 data may contain slightly different prevalence estimates.

The ACE Study Continues

States Collecting BRFSS ACE Data by Year, 2009-2014.

Map of the United States shows the states of Arkansas, California, Louisiana, New Mexico, Tennessee and Washington collected BRFSS data in 2009. The map also shows the District of Colombia, Florida, Hawaii, Maine, North Carolina, Nebraska, Nevada, Ohio, Pennsylvania, Utah, Vermont, Washington, and Wisconsin collected BRFSS data in 2010. In 2011, California, Maine, Minnesota, Montana, Nebraska, Nevada, Oregon, Vermont, Washington, and Wisconsin collected BRFSS data. In 2012 Connecticut, Iowa, North Carolina, Tennessee, and Wisconsin collected BRFSS data. Iowa, Michigan and Wisconsin collected BRFSS data in 2013. In 2014, Alaska, Arkansas, Kansas, Michigan, North Carolina, Oklahoma, Oregon, Pennsylvania, South Carolina, and Wisconsin collected BRFSS data.

BRFSS Prevalence of ACEs

Prevalence of ACEs by Category for Participants Completing the ACE Module on the 2010 BRFSS.

Two charts show the prevalence estimates reported from a total of 53,784 participants in Washington, DC and ten states (Hawaii, Maine, Nevada, Ohio, Pennsylvania, Utah, Vermont, Washington, and Wisconsin) that included the ACE module on the 2010 BRFSS. The first column represents reports of abuse. 35% reported emotional abuse; 16% reported physical abuse; and 11% reported sexual abuse. The second chart shows reports of household challenges. 15% reported intimate partner violence; 25% reported substance abuse; 16% reported mental illness in the household; 23% reported separation or divorce; and 6% reported incarceration of a household member.

Note: Reports and articles that use data from other years and/or other states may contain different estimates.

How Common are ACEs on BRFSS

ACE Score Prevalence for Participants Completing the ACE Module on the 2010 BRFSS.

Pie chart shows the prevalence of adverse childhood experiences by category among participants responding to ACE questions on the BRFSS in 2010. At the top of the chart reads How Common Are ACES? 41% of the participants reported zero adverse childhood experiences; 24% reported one; 13% reported two; 8% reported three; 14% reported four or more adverse childhood experiences.

Note: Reports and articles that use data from other years and/or other states may contain different estimates.

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