Want to learn more? 

www.cdc.gov/vitalsigns/aces

1 in 6 5 of 10 44%

NOV. 2019

#vitalsigns

Adverse Childhood Experiences 

impact lifelong health and 

opportunities. 

ACEs are common and the effects can 

add up over time.

• 61% of adults had at least one ACE and 

16% had 4 or more types of ACEs.

• Females and several racial/ethnic 

minority groups were at greater risk for 

experiencing 4 or more ACEs.

• Many people do not realize that exposure 

to ACEs is associated with increased risk 

for health problems across the lifespan.

PROBLEM:

Adverse Childhood Experiences (ACEs)

Preventing early trauma to improve adult health

Overview:

Adverse Childhood Experiences (ACEs) are 

potentially traumatic events that occur in childhood. 

ACEs can include violence, abuse, and growing 

up in a family with mental health or substance use 

problems. Toxic stress from ACEs can change brain 

development and affect how the body responds to 

stress. ACEs are linked to chronic health problems, 

mental illness, and substance misuse in adulthood. 

However, ACEs can be prevented. 

Preventing ACEs can help children and 

adults thrive and potentially:

• Lower risk for conditions like depression, 

asthma, cancer, and diabetes in adulthood.

• Reduce risky behaviors like smoking, and 

heavy drinking.

• Improve education and job potential.

• Stop ACEs from being passed from one 

generation to the next.

1 in 6 adults 

experienced four 

or more types 

of ACEs.

At least 5 of the 

top 10 leading 

causes of death 

are associated 

with ACEs.

Preventing ACEs 

could reduce the 

number of adults 

with depression by 

as much as 44%.
• Change how people think about the causes of ACEs and who 

could help prevent them.

• Shift the focus from individual responsibility to community 

solutions.

• Reduce stigma around seeking help with parenting challenges or 

for substance misuse, depression, or suicidal thoughts.

• Promote safe, stable, nurturing relationships and environments 

where children live, learn, and play.

THE WAY FORWARD

HEALTHCARE PROVIDERS CAN:

• Anticipate and recognize current 

risk for ACEs in children and history 

of ACEs in adults. Refer patients to 

effective services and support.

• Link adults to family-centered 

treatment approaches that include 

substance abuse treatment and 

parenting interventions.

EMPLOYERS CAN:

• Adopt and support family-friendly 

policies, such as paid family leave 

and flexible work schedules.

STATES AND COMMUNITIES CAN:

• Improve access to high-quality 

childcare by expanding eligibility, 

activities offered, and family 

involvement. 

• Use effective social and economic 

supports that address financial 

hardship and other conditions that 

put families at risk for ACEs. 

• Enhance connections to caring 

adults and increase parents’ and 

youth skills to manage emotions 

and conflicts using approaches in 

schools and other settings.

EVERYONE CAN:

• Recognize challenges that families 

face and offer support and 

encouragement to reduce stress.

• Support community programs 

and policies that provide safe and 

healthy conditions for all children 

and families. 

 http://go.usa.gov/xVvqD

For more information

1-800-CDC-INFO (232-4636)

TTY: 1-888-232-6348 | Web: www.cdc.gov

Centers for Disease Control and Prevention

1600 Clifton Road NE, Atlanta, GA 30333

Publication date: November 5, 2019 CS310418

Potential reduction of negative outcomes in adulthood

SOURCE: National Estimates based on 2017 BRFSS; Vital Signs, MMWR November 2019.

Raising awareness about ACEs can help:

Preventing ACEs could reduce a large number of health conditions.

SOURCE: BRFSS 2015-2017, 25 states, CDC Vital Signs, November 2019.

Heavy Drinking

-24% -33%

Current Smoking

Less than a High School

 Education

No Health Insurance

-15% -5% -4%

Unemployment

SOCIOECONOMIC 

CHALLENGES

HEALTH RISK 

BEHAVIORS

Chronic Obstructive 

 Pulmonary Disease

Asthma

Kidney Disease

Stroke

Coronary Heart Disease

Cancer

Diabetes

Overweight/ 

 Obesity

-24% -16% -15% -13% -6% -6% -2%

-27%

-44%

Depressive Disorder

HEALTH 

CONDITIONS

1.9 MILLION

CASES OF 

HEART DISEASE

UP TO

2.5 MILLION

CASES OF 

OVERWEIGHT/OBESITY 

UP TO

21 MILLION

CASES OF 

DEPRESSION

UP TO