The aforementioned limitations mean that this study’s results could overstate the economic value of preventing ACEs. However, there are multiple reasons that the results presented herein underestimate the economic burden of ACE-associated health conditions. This study addressed only health risk factors and outcomes previously assessed for association with ACEs using BRFSS or similar data that had DALY measures from the GBD study; this study did not investigate, for example, self-harm, suicide attempts, gastrointestinal conditions, musculoskeletal conditions beyond arthritis, or violence perpetration among adults who experienced ACEs. Results reflect the ACE-associated economic burden in adulthood but not childhood and available data on medical spending and DALYs excluded adults aged 18 to 19 years. This study examined the ACE-associated health burden among adults who experienced ACEs themselves but did not attempt to quantify later intergenerational effects.32 A focus limited to the health burden underestimates the total economic burden of ACEs; this study’s estimates do not include known ACE-associated socioeconomic outcomes in adulthood, including unemployment, crime, and social deprivation. This study mathematically combined numerous data inputs to produce point estimates of the economic
