Adverse childhood experiences (ACEs) are preventable, potentially traumatic events that occur in childhood, such as experiencing abuse or neglect, witnessing violence, or growing up in a household with substance use disorder, mental health problems, or instability due to parental separation or incarceration.1 These experiences have a documented dose-response association with negative adult health outcomes and risk behaviors—meaning the more ACEs a person has, the higher their risk for outcomes, such as depression, substance use disorder, and smoking, that remain after adjusting for household socioeconomic status during childhood.2 Research has estimated that one of the pathways by which ACEs affect these outcomes is prolonged activation of the stress-response system, which can harm the nervous, endocrine, and immune systems, leading to acute and lifelong consequences.3 Adverse childhood experience prevention strategies are associated with higher academic achievement and reductions in depression, suicidal behavior, arrest and incarceration rates, and substance use in adolescence and adulthood.1,3
