Compared to Merrick’s and colleagues’ study, our study is methodologically expanded in four important ways that help broaden the depth of ACEs prevalence. The first is that we collected data from 11 additional states that were not included in Merrick et al’s study (a 48% increase). With the additions of New Mexico, West Virginia, Kentucky, Ohio, Texas, Arkansas, Georgia, Hawaii, Louisiana, New York, and Illinois, we believe this expands the breadth of geographic available data on the topic and to our knowledge, is the most current and geographically comprehensive ACEs database to date. In particular, states classified in the South are especially understudied with respect to ACEs. For example, although Merrick and colleagues’ article was the most geographic expansive article to date, their analysis only included 5 of the 16 states in the South (31%), while our investigation includes 12 of the 16 states (75%). This is important due to preliminary data suggesting that southern states may have higher rates of adversity among children compared to other regions [21].
