5.8 KiB
| title | chunk | source | category | tags | date_saved | instance |
|---|---|---|---|---|---|---|
| Adverse childhood experiences | 1/6 | https://en.wikipedia.org/wiki/Adverse_childhood_experiences | reference | science, encyclopedia | 2026-05-05T15:31:17.921938+00:00 | kb-cron |
Adverse childhood experiences (ACEs) include childhood emotional, physical, or sexual abuse and household dysfunction during childhood. The categories are verbal abuse, physical abuse, sexual abuse, parental domestic violence, violence against women, household substance abuse, household mental illness, incarcerated household members, and parental separation or divorce. The topic has been raised as an important emerging public health issue and framework following the publication of the Adverse Childhood Experiences Study in 1998 by the US Centers for Disease Control and Prevention (CDC) and Kaiser Permanente.
== Definition and types ==
=== The original ACEs framework ===
==== Abuse ====
Physical abuse: causing physical harm, such as hitting, beating, or slapping. Emotional abuse: verbal threats, swearing at, insulting, or humiliating a child. Sexual abuse: abusive sexual behavior or contact.
==== Neglect ====
Physical neglect: failure to meet a child's basic physical needs, such as food, shelter, or clothing. Emotional neglect: failure to meet a child's basic emotional needs, including love or affection.
==== Household dysfunction ====
Witnessing violence against women: observing a woman in the family being treated violently. Household substance use: living with a household member who has a substance use disorder. Household mental illness: living with a household member who is mentally ill. Parental separation or divorce: experiencing the separation or divorce of parents. Incarcerated household member: having a household member serve time in jail or prison.
=== Community-Level ACEs === Exposure to ACEs is not limited to the home; they can also expand outside of the home and into the wider community. This can include:
Seeing or experiencing community violence. Discrimination or racism. Living in an unsafe neighborhood. Bullying. Living in foster care.
== Prevalence == Adverse childhood experiences are common across all parts of societies. In 2009, the US Centers for Disease Control and Prevention (CDC) started collecting data on the prevalence of ACEs as part of the Behavioral Risk Factor Surveillance System (BRFSS). In the first year data was collected across five US states and included over 24,000 people. The prevalence of each ACE ranged from a high of 29.1% for household substance abuse to a low of having an incarcerated family member (7.2%). Approximately one quarter (25.9%) of respondents reported verbal abuse, 14.8% reported physical abuse, and 12.2% reported sexual abuse. For ACEs measuring family dysfunction, 26.6% reported separated or divorced parents; 19.4% reported that they had lived with someone who was depressed, mentally ill, or suicidal; and 16.3% reported witnessing domestic violence. Men and women reported similar prevalences for each ACE, with the exception of sexual abuse (17.2% for women and 6.7% for men), living with a mentally ill household member (22.0% for women and 16.7% for men), and living with a substance-abusing family member (30.6% for women and 27.5% for men). Younger respondents more often reported living with an incarcerated and/or mentally ill household member. For each ACE, a sharp decrease was observed in prevalence reported by adults aged ≥55 years. For example, the prevalence of reported physical abuse was 16.9% among adults aged 18–24 years compared with 9.6% among those aged ≥55 years. Approximately 41% of respondents reported having no ACEs, 22% reported one ACE, and 8.7% reported five or more ACEs. Men (6.9%) were less likely to report five or more ACEs compared with women (10.3%). Respondents aged ≥55 years reported the fewest ACEs, but the younger age groups did not differ from one another. Non-Hispanic blacks were less likely to report five or more ACEs (4.9%) compared with non-Hispanic whites (8.9%), Hispanics (9.1%), and other non-Hispanics (11.7%). However, non-Hispanic black respondents were not significantly more likely to report zero ACEs compared with other racial/ethnic groups. Respondents with the lowest educational attainment were significantly more likely to report five or more ACEs compared with those with higher education levels (14.9% versus 8.7% among high school graduates and 7.7% in those with more than a high school education). Overall, little state-by-state variation was observed in the number of ACEs reported by each respondent. Sexual minority individuals have a higher prevalence of ACEs compared to heterosexual children. According to BRFSS data sexual minorities were more than twice as likely to report abuse, with bisexuals reporting the highest number of ACEs. This prevalence is slowly retreating with younger queer peoples experiencing fewer ACEs than previous generations, this should be tempered as ACEs are associated with early death. But rates among queer people of color are still some of the highest across all demographic groups, particularly among bisexual men and women of color. There are no reliable global estimates for the prevalence of child maltreatment. Data for many countries, especially low- and middle-income countries, are lacking. Current estimates vary widely depending on the country and the method of research used. Approximately 20% of women and 5–10% of men report being sexually abused as children, while 25–50% of all children report being physically abused. Research has also demonstrated that ACE scores are related to increased rates and severity of psychiatric and mental disorders, as well as higher rates of prescription psychotropic medication use and higher rates of substance abuse/addiction.
== Health outcomes due to ACEs ==