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PACEs Science

At PACEs Connection, we believe in following the research. In the last few years, researchers have started to examine the impacts of positive childhood experiences (PCEs) on children and adults. We at PACEs Connection are particularly interested in the in

PACEs Science: Epidemiology


  • ACEs Surveys in States 2009-2020
    This blog post includes a series of a dozen maps that record the progress of states and the District of Columbia (DC) to include the ACEs module in the Behavioral Risk Factor Surveillance System (BRFSS) survey. Starting with six states in 2009, now all 50 states and DC include the module. Here is the link to CDC’s information on the Behavioral Risk Factor Surveillance System (BRFSS) ACEs module data.

  • Association of Childhood Adversity with Morbidity and Mortality in US Adults: A systematic review, 2021
    The results of this systematic review suggest that childhood adversity is a leading contributor to morbidity and mortality in the US and may be considered a preventable determinant of mortality. The prevention of CA and the intervention on pathways that link these experiences to elevated disease risk should be considered a critical public health priority.
    [Grummit, L.R., Kreski, N.T., Kim, S.G., et al., (2021). Association of Childhood Adversity with Morbidity and Mortality in US Adults: A systematic review. JAMA Pediatrics. doi:10.1001/jamapediatrics.2021.2320]

  • Adverse Childhood Experiences During the COVID-19 Pandemic and Associations with Poor Mental Health and Suicidal Behaviors Among High School Students — Adolescent Behaviors and Experiences Survey, United States, January–June 2021, 2022
    The prevalences of poor current mental health and past-year suicide attempts among adolescents reporting four or more ACEs during the COVID-19 pandemic were four and 25 times as high as those without ACEs, respectively. Exposure to specific ACE types (e.g., emotional abuse) were associated with higher prevalences of poor mental health and suicidal behaviors.
    [Anderson, K.N., Swedo, E.A., Trinh, E., et al. (2022). Adverse Childhood Experiences During the COVID-19 Pandemic and Associations with Poor Mental Health and Suicidal Behaviors Among High School Students — Adolescent Behaviors and Experiences Survey, United States, January–June 2021. MMWR Morb Mortal Wkly Rep, 71:1301–1305. DOI:]

  • Disparities in Adverse Childhood Experiences by Race/Ethnicity, Gender, and Economic Status: Intersectional Analysis of a Nationally Representative Sample, 2021
    This study analyzes data from the National Longitudinal Study of Adolescent to Adult Health, a nationally representative sample in the U.S., to explore variation in ACEs by race/ethnicity, economic status, and gender. Descriptively, the authors found that ACEs are more prevalent overall among the poor than the non-poor, among most racial/ethnic minority groups than non-Hispanic Whites, and among females than males. However, multivariate regression results indicate that gender is not a robust correlate of cumulative adversity and that economic status moderates racial/ethnic differences. MAIHDA models further expose heterogeneity in aggregate ACE scores between intersectional strata representing unique combinations of gender, race/ethnicity, and economic status. The MAIHDA results confirm that conclusions based on unadjusted group differences may be spurious. While most variance in ACE scores is explained by additive main effects, accounting for intersections among social categories generates a more complex portrait of inequality. 
    [Mersky, J.P., Choi, C., Lee, C.P., Janczewski, C.E. (2021). Disparities in adverse childhood experiences by race/ethnicity, gender, and economic status: Intersectional analysis of a nationally representative sample. Child Abuse & Neglect, 117, 105066.]

  • Prevalence of Adverse Childhood Experiences (ACEs) among US Children, 2019
    Data from the nationally representative 2016 National Survey of Children's Health (NSCH). Parent-reported child ACE exposure was measured using counts of those reporting zero ACEs, one to three ACEs, and four or more ACEs. 
    [Crouch, E., Probst, J.C., Radcliff, E., Bennett, K.J., & McKinney, S.H. (2019). Prevalence of adverse childhood experiences (ACEs) among US children. Child Abuse Negl., 92, 209-218.]

  • The Prevalence of Adverse Childhood Experiences, Nationally, by State, and by Race or Ethnicity, 2018
    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.
    [Sacks, V., Murphey, D.. (2018). The prevalence of adverse childhood experiences, nationally, by state, and by race or ethnicity. Child Trends,]

  • Racial/Ethnic Differences in Positive Childhood Experiences across a National Sample, 2021
    The information from this study highlights the negative disparities borne by racial/ethnic minority populations. Findings can be used to inform policymakers, program developers, and stakeholders on where to target interventions and how to bring together families and communities to not only confront adversity in childhood, but also to leverage community and family-level assets to create PCEs for all children. 
    [Crouch, E., Radcliff, E., Merrell, M.A., Brown, M.J., Ingram, L.A., & Probst, J. (2021). Racial/ethnic differences in positive childhood experiences across a national sample. Child Abuse Negl., 115, 105012.]

  • Vital Signs: Estimated Proportion of Adult Health Problems Attributable to Adverse Childhood Experiences and Implications for Prevention — 25 States2015–2017 
    Adverse childhood experiences, such as violence victimization, substance misuse in the household, or witnessing intimate partner violence, have been linked to leading causes of adult morbidity and mortality. Therefore, reducing adverse childhood experiences is critical to avoiding multiple negative health and socioeconomic outcomes in adulthood. 
    [Merrick, M.T., Ford, D.C., Ports, K.A., Guinn, A.S., Chen, J., Klevens, J., Metzler, M., Jones, C.M., Simon, T.R., Daniel, V.M., Ottley, P., & Mercy, J.A. (2019). Vital signs: Estimated proportion of adult health problems attributable to adverse childhood experiences and implications for prevention — 25 states, 2015–2017. MMWR Morb Mortal Wkly Rep, 68, 999-1005.]