A total of 820 673 adults, representing 255 million individuals, participated in the BRFSS in 2019 and 2020. An estimated 160 million of the total 255 million US adult population (63%) had 1 or more ACE (Table 1). This includes an estimated 46 million adults (18%) with 1 ACE, 56 million adults (22%) with 2 to 3 ACEs, and 57 million adults (22%) with 4 or more ACEs. Higher ACE count corresponded with a higher prevalence of most of the analyzed conditions; for example, less than 5% of adults with 0 ACEs had depression compared with more than 7% of adults with 1 ACE, more than 18% of adults with 2 to 3 ACEs, and 48% of adults with 4 or more ACEs (Table 2). Adjusted odds ratios for all analyzed conditions indicated a significantly higher prevalence among adults with ACEs (Table 2). For example, the AOR for smoking among adults with 4 or more ACEs was 6.48 (95% CI, 6.20-6.78), indicating that adults with that ACE count were more than 6 times as likely to smoke as other adults.
