Almost four out of every ten children have had at least one adverse childhood experience (ACE), a study from the Johns Hopkins Bloomberg School of Public Health finds.

According to an issue brief (8 pages, PDF) based on data from a survey conducted by the Child & Adolescent Health Measurement Initiative (CAHMI), at least 25 percent of children in sixteen states have had two or more ACEs, which include things like the death or incarceration of a parent, witnessing or being a victim of violence, or living with someone who has been suicidal or had a drug or alcohol problem. Nationally, more than 46 percent of U.S. youth — 34 million children under the age of 18 — have had at least one ACE, and more than 20 percent have had at least two. Supported by the Robert Wood Johnson Foundation, the issue brief includes the percentage of children who have had an ACE by state, ranging from 38.1 percent in Minnesota to 55.9 percent in Arkansas. The ten states with the highest rates are either in the South or West.

Adverse childhood experience can have serious long-term effects on a child's health and well-being, contributing to high levels of toxic stress that derail healthy physical, social, emotional, and cognitive development. Research shows that ACEs also increase the long-term risk for smoking, alcoholism, depression, heart and liver diseases, and dozens of other illnesses and unhealthy behaviors. The latest analysis found that 33 percent of children with two or more ACEs have a chronic health condition involving a special healthcare need, compared to 13.6 percent of children without ACEs.

The issue brief found that ACEs affect children and families across racial, ethnic, and socioeconomic groups. For example, while white children are less likely to have had an ACE than Hispanic or African-American children, whites make up the largest cohort of all children who have had an ACE. The study also found that children whose parents report "always" having positive communication with their child's healthcare providers are over 1.5 times more likely to have established family routines and habits such as eating meals together, reading together, limiting screen time, and not using tobacco at home that can protect against ACEs.

"Every child deserves a healthy start. A loving home, a good school, a safe neighborhood — these things are the foundation for a long and happy life, yet too many children don't have them," said RWJF president and CEO Richard Besser. "Too often, children experience trauma that can be devastating. But trauma doesn't have to define a child's life trajectory. They can be incredibly resilient. With policies that help families raise healthy children, and the consistent presence of caring adults in their lives, we can reduce the impact of trauma on children's health and help them thrive in the face of adversity."