ACE Fundamentals

Adverse Childhood Experiences (ACEs) are not destiny

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Adverse Childhood Experiences (ACEs)

Adverse Childhood Experiences (ACEs) are potentially traumatic events that occur when we are young. ACEs and the associated toxic stress they create are the root causes of some of the most common, serious, and costly health and social challenges facing our state. In fact, ACEs are strongly linked to 9 of the 10 leading causes of death in the United States. (1) (2)

ACEs affect all communities and cross racial, ethnic, socioeconomic, gender, and geographic lines. Two-thirds of us have at least one ACE.

The term “ACEs” refers to 10 categories of adversities in three domains experienced by 18 years of age that were identified in the landmark 1998 study by the Centers for Disease Control and Prevention (CDC) and Kaiser Permanente. (3) (4)

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The life expectancy of individuals with six or more ACEs is 19 years shorter than that of individuals with none. (5)

The good news is that toxic stress is treatable. A consensus of scientific data demonstrates that early detection and intervention are associated with improved outcomes related to toxic stress.

ACEs are not destiny. We have the power to make a difference.

By screening for ACEs to assess the risk of toxic stress and effectively responding with evidence-based, trauma-informed care across sectors, we can significantly improve the health and well-being of individuals and families for generations to come.


1: Merrick MT, Ford DC, Ports KA, Guinn AS. Prevalence of adverse childhood experiences from the 2011-2014 Behavioral Risk Factor Surveillance System in 23 states. JAMA Pediatrics 2018; 172: 1038.
2: Centers for Disease Control and Prevention. Leading causes of death by age group 2017. (accessed May 8, 2019).
3: Felitti VJ, Anda RF, Nordenberg D, et al. Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults. American Journal of Preventive Medicine 1998; 14: 245–58.
4: Dube SR, Felitti VJ, Dong M, Giles WH, Anda RF. The impact of adverse childhood experiences on health problems: evidence from four birth cohorts dating back to 1900. Preventive Medicine 2003; 37: 268–77.
5: Brown DW, Anda RF, Tiemeier H, et al. Adverse childhood experiences and the risk of premature mortality. American Journal of Preventive Medicine 2009; 37: 389–96.