Adverse childhood experiences (ACEs) are preventable and traumatic events that occur before eighteen (18) years of age.# The Centers for Disease Control and Prevention (CDC) published the first report outlining the national prevalence of self-reported adverse childhood experiences (ACEs) among high school students in the United States.# This report analyzes the associations between the exposure to adverse childhood experiences (ACEs) and an estimated sixteen (16) health conditions and risk behaviors.#
Estimated exposures included the lifetime prevalence of individual (emotional, physical, and sexual abuse; physical neglect; witnessed intimate partner violence; household substance use; household poor mental health; and incarcerated or detained parent or guardian) adverse childhood experiences (ACEs) and a cumulative count of adverse childhood experiences (ACEs).# Health conditions and risk behaviors included violence risk factors, substance use, sexual behaviors, weight and weight perceptions, mental health, and suicidal thoughts and behaviors.#
“Adverse childhood experiences (ACEs) are prevalent among students and contribute substantially to numerous health conditions and risk behaviors in adolescence. Public health professionals can use these findings to understand the potential public health impact for the prevention of adverse childhood experiences (ACEs) to reduce adolescent suicidal behaviors, substance use, sexual risk behaviors, other negative health conditions and risk behaviors, and to understand current effects of adverse childhood experiences (ACEs) among high school students in the United States.”
According to the Centers for Disease Control and Prevention (CDC), adverse childhood experiences (ACEs) are associated with an increased likelihood of various risk factors and health outcomes, including being in physical fights and carrying weapons; smoking, alcohol use, and illicit drug use in both adolescence and adulthood; early sexual initiation, teenage pregnancy, sexually transmitted infections (STIs), and multiple sexual partners; overweight or obesity; and various mental health conditions or symptoms, including suicide risk.#
“The most common adverse childhood experiences (ACEs) were emotional abuse (61.5%), physical abuse (31.8%), and household poor mental health (28.4%). Experiences of specific adverse childhood experiences (ACEs) varied by demographic characteristics. All adverse childhood experiences (ACEs), except physical neglect, were more common among female students than male students.
Unique patterns were observed by race and ethnicity for individual adverse childhood experiences (ACEs). For example, American Indian/Alaska Native students had the highest prevalence of witnessed intimate partner violence (28.7%) and household substance use (34.2%), but some of the lowest estimates of prevalence for physical abuse (35.7%). Asian students had the lowest prevalence of sexual abuse (4.3%), witnessed intimate partner violence (17.1%), household substance use (12.4%), household poor mental health (13.2%), and parent or guardian incarcerated or detained (4.6%), but had the highest prevalence of physical abuse (38.2%), along with Black students (38.2%).”
As the number of adverse childhood experiences (ACEs) increased for most conditions and behaviors, the adjusted prevalence ratios (a value calculated using a regression that adjusts for specific factors [age, sex, race, income, employment, education, etc.]) between the count of cumulative adverse childhood experiences (ACEs) and health condition or risk behavior increased in magnitude, indicating a dose-response relationship (relationship in which increasing levels of exposure are associated with either an increasing or a decreasing risk of the outcome).#
For ten (10) of the sixteen (16) conditions and behaviors, those experiencing one (1) adverse childhood experience (ACE) had a significantly higher prevalence of each health condition or risk behavior than those experiencing zero (0) adverse childhood experiences (ACEs).# Those experiencing two (2) or more adverse childhood experiences (ACEs) had a significantly higher prevalence of almost all conditions and behaviors when compared to those with zero (0) adverse childhood experiences (ACEs).# The Centers for Disease Control and Prevention (CDC) reports that the strongest associations were observed among those experiencing four (4) or more adverse childhood experiences (ACEs).#
These findings must be implemented to guide future interventions for the prevention of adverse childhood experiences (ACEs) and for reducing adolescent suicidal behaviors, substance use, sexual risk behaviors, and other negative health conditions and risk behaviors among high school students in the United States.#