About adverse childhood experiences or traumas
Centers for Disease Control and Prevention (CDC)
What are adverse childhood experiences?
Adverse childhood experiences, or ACEs, are potentially traumatic events that occur in childhood, up to the age of 17 years. Examples include:
• Experiencing violence, abuse, or neglect.
• Witnessing violence in the home or community.
• Having a family member attempt or die by suicide.
• Aspects of the child’s environment that can undermine their sense of safety, stability, and bonding, such as growing up in a household with:
• Substance use problems.
• Mental health problems.
• Instability due to parental separation.
• Instability due to household members being in jail or prison.
The examples above are not a complete list of adverse experiences. Many other traumatic experiences could impact health and well-being, such as:
• Not having enough food to eat.
• Experiencing homelessness.
• Unstable housing.
• Experiencing discrimination.
Facts and statistics
ACEs are common. About 64% of adults in the United States reported they had experienced at least one type of ACE before age 18. Nearly one in six (17.3%) adults reported they had experienced four or more types of ACEs.
Preventing ACEs could potentially reduce many health conditions. Estimates show up to 1.9 million heart disease cases and 21 million depression cases potentially could have been avoided by preventing ACEs.
Some people are at greater risk of experiencing one or more ACEs than others. While all children are at risk of ACEs, numerous studies show inequities in such experiences. These inequalities are linked to the historical, social, and economic environments in which some families live. ACEs were highest among females, non-Hispanic American Indian or Alaska Native adults, and adults who are unemployed or unable to work.
ACEs are costly. ACEs-related health consequences cost an estimated economic burden of $748 billion annually in Bermuda, Canada, and the United States.
Outcomes of adverse childhood experiences (ACEs)
ACEs can have lasting effects on health and well-being in childhood and life opportunities well into adulthood. Life opportunities include things like education and job potential. These experiences can increase the risks of injury, sexually transmitted infections, and involvement in sex trafficking. They can also increase risks for maternal and child health problems including teen pregnancy, pregnancy complications, and fetal death. Also included are a range of chronic diseases and leading causes of death, such as cancer, diabetes, heart disease, and suicide.
ACEs and associated social determinants of health, such as living in under-resourced or racially segregated neighborhoods, can cause toxic stress. Toxic stress, or extended or prolonged stress, from ACEs can negatively affect children’s brain development, immune systems, and stress-response systems. These changes can affect children’s attention, decision-making, and learning.
Children growing up with toxic stress may have difficulty forming healthy and stable relationships. They may also have unstable work histories as adults and struggle with finances, jobs, and depression throughout life. These effects can also be passed on to their own children. Some children may face further exposure to toxic stress from historical and ongoing traumas. These historical and ongoing traumas refer to experiences of racial discrimination or the impacts of poverty resulting from limited educational and economic opportunities.
Prevention of adverse childhood experiences (ACEs)
Adverse childhood experiences can be prevented. Certain factors may increase or decrease the risk of experiencing adverse childhood experiences. Watch this video to learn more: cdc.gov/aces/about/index.html.
Preventing adverse childhood experiences requires understanding and addressing the factors that put people at risk for or protect them from violence.
Creating safe, stable, nurturing relationships and environments for all children can prevent ACEs and help all children reach their full potential. We all have a role to play.