The Prevalence of Adverse Childhood Experiences, Nationally, by State, and by Race or Ethnicity

A growing body of research has made it increasingly apparent that adverse childhood experiences (ACEs) are a critical public health issue. ACEs are potentially traumatic experiences and events, ranging from abuse and neglect to living with an adult with a mental illness. They can have negative, lasting effects on health and well-being in childhood or later in life.¹ However, more important than exposure to any specific event of this type is the accumulation of multiple adversities during childhood, which is associated with especially deleterious effects on development.²

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There is growing interest in understanding the prevalence of these experiences across different communities in the United States, and how to prevent and respond to them. One mechanism responsible for these effects—toxic levels of stress—can be substantially buffered by a stable and supportive relationship with a caregiver.

This brief uses data from the 2016 National Survey of Children’s Health (NSCH) to describe the prevalence of one or more ACEs among children from birth through age 17, as reported by a parent or guardian. The data are representative at national and state levels. The study team estimated the national prevalence of eight specific ACEs and compared the prevalence of these ACEs across states. To examine prevalence differences by race/ethnicity and geography, we used the nine geographic divisions used by the U.S. Census Bureau.³

– Just under half (45 percent) of children in the United States have experienced at least one ACE, which is similar to the rate of exposure found in a 2011/2012 survey.* In Arkansas, the state with the highest prevalence, 56 percent of children have experienced at least one ACE.

– One in ten children nationally has experienced three or more ACEs, placing them in a category of especially high risk. In five states—Arizona, Arkansas, Montana, New Mexico, and Ohio—as many as one in seven children had experienced three or more ACEs.

– Children of different races and ethnicities do not experience ACEs equally. Nationally, 61 percent of black non-Hispanic children and 51 percent of Hispanic children have experienced at least one ACE, compared with 40 percent of white non-Hispanic children and only 23 percent of Asian non-Hispanic children. In every region, the prevalence of ACEs is lowest among Asian non-Hispanic children and, in most regions, is highest among black non-Hispanic children.

* Child Trends reported on these data in an earlier publication: Adverse Childhood Experiences: National and State-level Prevalence. The Health Resources and Services Administration’s Maternal and Child Health Bureau and the Child and Adolescent Health Measurement Initiative’s Data Resource Center caution against making direct comparisons of 2016 data with those collected in earlier waves of the survey, because of design changes in 2016.