What are adverse childhood experiences?
Adverse childhood experiences, or ACEs, are traumatic experiences and events—like physical abuse, neglect, or witnessing violence in the home—that happen before age 18, but can have a lasting, negative effect on our lives throughout adulthood. According to Wisconsin Behavioral Risk Factor Surveillance Survey data from 2017 to 2018, 59% of Wisconsin residents surveyed reported at least one ACE in the past. And research shows that the more ACEs a person has, the higher their risk for mental, physical, and behavioral health challenges later in life.
Like trauma and toxic stress, ACEs are both a cause and a consequence of behavioral risks like harmful substance use. This can create a cycle of adversity and “inherited” trauma that can affect families for generations. For example, children who are exposed to a parent with substance use disorders are more likely to develop substance use disorder symptoms themselves.
Fortunately, ACEs and the harms they cause can be prevented, or at least lessened, when parents and other caring adults provide children with safe, stable, and nurturing relationships and environments.
Know the risks
Adverse childhood experiences include:
- Abuse: Specifically, emotional, physical, and sexual abuse
- Neglect: Both physical and emotional neglect
- Household dysfunction: Witnessing violence in the home, harmful substance use, mental illness, separated or divorced parents, or an incarcerated caregiver or loved one.
Like trauma and toxic stress, ACEs are both a cause and a consequence of behavioral risks like harmful substance use. This can create a cycle of adversity and "inherited" trauma that can affect families for generations. For example, children who are exposed to a parent with a substance use disorder are more likely to develop a substance use disorder symptoms themselves.
Fortunately, ACES and the harms they cause can be prevented, or at least lessened, when parents and other caring adults provide children with safe, stable, and nurturing relationships and environments.
The impact of ACEs in Wisconsin
ACEs are more common than you might think. A person’s ACEs score is a tally of the early adversities they faced before age 18. In Wisconsin, nearly 60% of adults say they experienced at least one ACE while growing up, while 16% report an ACEs score of 4 or more. From Beloit to the Apostle Islands, people of every age and from all walks of life are living with, or are affected by, the harmful consequences of early adversity.
Explore the latest Wisconsin-specific data to see the populations and negative health outcomes most tightly linked to ACEs in our state today.
ACEs and Wisconsin populations
ACEs by household income
There is a clear connection between ACEs and economic stability. In Wisconsin, individuals who earn less than $25,000 each year are two times more likely than those with a household income of at least $50,000 to have an ACEs score of four or more.
Source: 2017-2018 Wisconsin Behavioral Risk Factor Surveillance Survey
ACEs by race or ethnicity
Some racial or ethnic populations in Wisconsin experience higher ACEs scores than others. These numbers do not account for racial or ethnic sub-populations, like lesbian, gay, bisexual, transgender, or queer (LGBTQ) communities of color. Members of such sub-populations may face a higher risk for ACEs or may have higher ACEs scores.
Source: 2015-2018 Wisconsin Behavioral Risk Factor Surveillance Survey
ACEs and health conditions
ACEs and mental health
Early adversity is linked to poor health later in life. When we examine the ACEs scores of Wisconsin residents living with mental or physical health conditions, we see that, in nearly every case, rates of negative health outcomes rise as individuals’ ACEs scores increase.
Source: 2017-2018 Wisconsin Behavioral Risk Factor Surveillance Survey
ACEs and physical health
Source: 2017-2018 Wisconsin Behavioral Risk Factor Surveillance Survey
ACEs and substance use
ACEs and opioid use
People in Wisconsin with an ACEs score of four or higher are more than two times as likely to have used a prescription opioid in the last 12 months than individuals with zero ACEs. Opioid use, even when used as prescribed by a doctor, can lead to harmful substance use and addiction.
Source: 2017-2018 Wisconsin Behavioral Risk Factor Surveillance Survey
ACEs and smoking tobacco
Cigarette smoking is a high-risk behavior associated with heart disease, COPD, certain cancers and other negative health outcomes. In Wisconsin, individuals with four or more ACEs are three times more likely to smoke cigarettes than those with an ACEs score of zero.
Source: 2017-2018 Wisconsin Behavioral Risk Factor Surveillance Survey
Adversity in your past does not determine your future
While they have become an important way to forecast an individual’s health risks, it’s important to remember that ACEs are not a crystal ball, and outcomes cannot be predicted. They don’t account for protective factors that may have reduced the impact of early adversity, or increased the resilience individuals build with time and experience.
That’s why using ACEs scores, the number of ACEs an individual has, as a tool to identify the root causes of trauma may be a more beneficial use of ACEs research than focusing on individuals’ risks. Used this way, ACEs can help mental and behavioral health professionals develop early intervention efforts that support young people disproportionately impacted by risk factors. Their use can also help communities develop resilience-building resources and policies they need to overcome a wide range of entrenched public health challenges.
WATCH: Resilience: The Path to Hope and Meaning
This exclusive training webcast for people working in helper professions provides an overview of ACES and trauma, explores ACEs data in Wisconsin, and highlights strategies to build resilience. Watch the video. Contact Resilient Wisconsin with questions about this training.
Learn more
Want to learn more about ACEs and their impact on Wisconsin? Check out these additional resources.
Take a closer look at the essential principles, evidence-based frameworks, and best practices that help public health professionals and others understand and promote resilience in our communities and organizations, in our relationships, and within ourselves.
