This economic evaluation observed that among the 63% of US adults who had 1 or more ACE, the associated annual economic burden was $14.1 trillion in medical spending and lost healthy life-years from related chronic disease and risk factors for ill health in adulthood. This is $88 000 per affected adult annually and $2.4 million over their lifetimes. The burden was highest among adults who had multiple ACEs. Childhood adversity may be reduced through targeted strategies that strengthen economic supports for families, promote social norms that protect against violence and adversity, teach skills to help parents and youth handle stress and manage emotions and tackle everyday challenges, connect youth to caring adults and activities, and intervene to lessen immediate and long-term harms.1 The estimated economic burden of ACEs reported herein, in terms of direct costs such as medical spending or more expansively evaluated in terms of societal cost, may be useful in decision-making on the present value of investment in such strategies to prevent ACEs.
