The DOI matches its Crossref record; 7 of the 7 references it cites were found in a registry or an index.
Prevalence of adverse childhood experiences among U.S. adults—Behavioral Risk Factor Surveillance System, 2011–2020.
Open accessAbstract
Adverse childhood experiences (ACEs) are defined as preventable, potentially traumatic events that occur among persons aged <18 years and are associated with numerous negative outcomes; data from 25 states indicate that ACEs are common among U.S. adults (1). Disparities in ACEs are often attributable to social and economic environments in which some families live (2,3). Understanding the prevalence of ACEs, stratified by sociodemographic characteristics, is essential to addressing and preventing ACEs and eliminating disparities, but population-level ACEs data collection has been sporadic (1). Using 2011-2020 Behavioral Risk Factor Surveillance System (BRFSS) data, CDC provides estimates of ACEs prevalence among U.S. adults in all 50 states and the District of Columbia, and by key sociodemographic characteristics. Overall, 63.9% of U.S. adults reported at least one ACE; 17.3% reported four or more ACEs. Experiencing four or more ACEs was most common among females (19.2%), adults aged 25-34 years (25.2%), non-Hispanic American Indian or Alaska Native (AI/AN) adults (32.4%), non-Hispanic multiracial adults (31.5%), adults with less than a high school education (20.5%), and those who were unemployed (25.8%) or unable to work (28.8%). Prevalence of experiencing four or more ACEs varied substantially across jurisdictions, from 11.9% (New Jersey) to 22.7% (Oregon). Patterns in prevalence of individual and total number of ACEs varied by jurisdiction and sociodemographic characteristics, reinforcing the importance of jurisdiction and local collection of ACEs data to guide targeted prevention and decrease inequities. CDC has released prevention resources, including Preventing Adverse Childhood Experiences: Leveraging the Best Available Evidence, to help provide jurisdictions and communities with the best available strategies to prevent violence and other ACEs, including guidance on how to implement those strategies for maximum impact (4-6).
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“Approximately two thirds of U.S. adults have experienced at least one ACE and 17% of U.S. adults have experienced four or more ACEs (4).”
From Adverse childhood experiences and health conditions and risk behaviors among high school students—Youth Risk Behavior Survey, United States, 2023 (2024) · cites this paper as [4]
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Adverse childhood experiences and the risk of premature mortality
Brown, D. W., Anda, R. F., Tiemeier, H., Felitti, V. J., Edwards, V. J., Croft, J. B., & Giles, W. H. (2009) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2009.06.021 · Cited by 1,369
Adverse childhood experiences and life opportunities: shifting the narrative
Metzler, M., Merrick, M. T., Klevens, J., Ports, K. A., & Ford, D. C. (2017) · Children and Youth Services Review · doi:10.1016/j.childyouth.2016.10.021 · Cited by 713
Merrick, M. T., Ford, D. C., Ports, K. A., Guinn, A. S., Chen, J., Klevens, J., Metzler, M. M., Jones, C. M., Simon, T. R., Daniel, V. M., et al. (2019) · MMWR Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6844e1 · Cited by 698
Sedlak, A. J., Mettenburg, J., Basena, M., Petta, I., McPherson, K. S., Greene, A., & Li, S. (2010) · PsycEXTRA Dataset · doi:10.1037/e565022012-001 · Cited by 514
National Center for Injury Prevention and Control (U.S.). Division of Violence Prevention., Fortson, B. L., Klevens, J., Merrick, M. T., Gilbert, L. K., & Alexander, S. P. (2016) · doi:10.15620/cdc.38864 · Cited by 334
Font, S. A., & Maguire‐Jack, K. (2015) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2015.05.013 · Cited by 252
Identifying and Preventing Adverse Childhood Experiences
Jones, C. M., Merrick, M. T., & Houry, D. (2019) · JAMA · doi:10.1001/jama.2019.18499 · Cited by 164
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Economic Burden of Health Conditions Associated With Adverse Childhood Experiences Among US Adults
Peterson, C., Aslam, M. V., Niolon, P. H., Bacon, S., Bellis, M. A., Mercy, J. A., & Florence, C. (2023) · JAMA Network Open · doi:10.1001/jamanetworkopen.2023.46323 · Cited by 91
Self-citationSwedo, E. A., Pampati, S., Anderson, K. N., Thorne, E., McKinnon, I. I., Brener, N. D., Stinson, J., Mpofu, J. J., & Niolon, P. H. (2024) · MMWR Supplements · doi:10.15585/mmwr.su7304a5 · Cited by 89
The evolving neurobiology of early-life stress
Birnie, M. T., & Baram, T. Z. (2025) · Neuron · doi:10.1016/j.neuron.2025.02.016 · Cited by 72
Childhood verbal abuse as a child maltreatment subtype: A systematic review of the current evidence
Dube, S. R., Li, E. T., Fiorini, G., Lin, C., Singh, N., Khamisa, K., McGowan, J., & Fonagy, P. (2023) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2023.106394 · Cited by 64
Almeida, T. C., Cardoso, J., Matos, A. F., Murça, A., & Cunha, O. S. (2024) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2024.106929 · Cited by 54
Metadata
- Authors
- Swedo, E. A., Aslam, M. V., Dahlberg, L. L., Niolon, P. H., Guinn, A. S., Simon, T. R., & Mercy, J. A.
- Corresponding author
- Swedo, Elizabeth A.
- Venue
- MMWR Morbidity and Mortality Weekly Report
- Published
- 2023-06-30
- Volume
- 72
- Issue
- 26
- Pages
- 707-715
- ISSN
- 0149-2195 (ISSN-L)
- 1545-861X
- PMC
- PMC10328489
- OpenAlex
- W4382632554
- Cited by
- 386
- References
- 7
- Citations by year
- 2026: 146 · 2025: 147 · 2024: 86 · 2023: 7
- FWCI
- 112.53
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- MMWR Morbidity and Mortality Weekly Report (publishedVersion)
- PubMed Central (publishedVersion, public-domain)
- PubMed (publishedVersion)
- Funders
- State of Connecticut Department of Public Health
- Louisiana Department of Health
- Centers for Disease Control and Prevention
- National Center for Chronic Disease Prevention and Health Promotion
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Sociology and Political Science › Child Welfare and Adoption
- Social Sciences › Health › Intimate Partner and Family Violence
- Keywords
- adverse childhood experiences, prevalence, sociodemographic disparities, American Indian and Alaska Native adults, unemployment, educational attainment, sex differences, state-level variation, Behavioral Risk Factor Surveillance System
- MeSH terms
- Adverse Childhood Experiences, Adult, Female, Humans, Violence, Prevalence, Behavioral Risk Factor Surveillance System
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