Adverse Childhood Experiences
Adverse childhood experiences include verbal, physical, and sexual abuse, as well as forms of family dysfunction such as having a substance-abusing household member or witnessing domestic violence.1 Exposure to these types of traumatic experiences early in life has been associated with many mental and physical health problems throughout the lifespan, including substance abuse, depression, cardiovascular disease, and premature death.2,3
In 2009–2010 among a 7-State reporting area, more than one-in-four women (26.0 percent) reported that they had been verbally abused as a child on more than one occasion— defined as being sworn at, insulted or put down by a parent or adult in the home—and about 15 percent reported that they had ever been physically or sexually abused as a child (15.4 and 15.7 percent, respectively). Types of childhood family dysfunction among women ranged from 6.1 percent who reported that a household member had gone to prison to more than a quarter who had a substance-abusing household member (29.1 percent) or whose parents separated or divorced (25.2 percent). Compared to men, women were more than twice as likely to have experienced sexual abuse (15.7 versus 6.5 percent, respectively) and were also more likely to report having had a mentally ill or substance-abusing household member.
The likelihood of negative health outcomes later in life increases with the number of adverse childhood experiences.37 Among the 7-State reporting area in 2009–2010, 9.6 percent of women reported having five or more adverse experiences in childhood. Women with less than a high school education were most likely to have reported five or more adverse childhood experiences (17.0 percent) while college-educated women were least likely to have endured five or more adverse childhood experiences (6.5 percent).
1 Centers for Disease Control and Prevention. The Adverse Childhood Experiences Study. Accessed 10/26/12.
2 Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med. 1998;14(4):245-58.
3 Brown DW, Anda RF, Tiemeier H, Felitti VJ, Edwards VJ, Croft JB, Giles WH. Adverse childhood experiences and the risk of premature mortality. Am J Prev Med. 2009;37(5):389-96.
|Type of Experience||Percent of Adults|
|*Report of adverse experiences that occurred prior to 18 years of age; physical abuse did not include spanking.
**Arkansas and Louisiana contributed data in 2009 and DC, Hawaii, Nevada, Vermont, and Wisconsin contributed data in 2010. Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, 2009- 2010. Analysis conducted by the Maternal and Child Health Bureau.
|Verbally Abused More than Once||26.0||27.2|
|Ever Physically Abused||15.4||15.4|
|Ever Sexually Abused||15.7||6.5|
|Had Mentally Ill Household Member||19.2||13.7|
|Had Household Member that Went to Prison||6.1||7.2|
|Had Substance-Abusing Household Member||29.1||25.3|
|Ever Witnessed Domestic Violence||16.7||15.4|
Five or More Adverse Childhood Experiences* Among Women Aged 18 and Older in 7 States,** By Education Level, 2009-2010
Percent of Women:
- Total: 9.6
- Less than High School: 17.0
- High School: 10.0
- Some College or Technical School: 10.9
- College: 6.5
*Report of five or more types of adverse experiences that occurred prior to 18 years of age (types listed in previous figure).
**Arkansas and Louisiana contributed data in 2009 and DC, Hawaii, Nevada, Vermont, and Wisconsin contributed data in 2010.
Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, 2009- 2010. Analysis conducted by the Maternal and Child Health Bureau.