Public Health and Primary CareBRIEF REPORT

Trends and forecasted rates of adverse childhood experiences among adults in the United States: an analysis of the Behavioral Risk Factor Surveillance System

Micah Hartwell, PhD; Amy Hendrix-Dicken, MA; Rachel Terry, BS; Sadie Schiffmacher, BS; Lauren Conway, DO; and Julie M. Croff, PhD
Notes and Affiliations
Notes and Affiliations

Received: November 4, 2022

Accepted: February 27, 2023

Published: March 22, 2023

  • Micah Hartwell, PhD, 

    Oklahoma State University College of Osteopathic Medicine at Cherokee Nation, Office of Medical Student Research, Tahlequah, OK, USA

  • Amy Hendrix-Dicken, MA, 

    Department of Paediatrics, University of Oklahoma, School of Community Medicine, Tulsa, OK, USA

  • Rachel Terry, BS, 

    Oklahoma State University College of Osteopathic Medicine, Office of Medical Student Research, Tulsa, OK, USA

  • Sadie Schiffmacher, BS, 

    Oklahoma State University College of Osteopathic Medicine at Cherokee Nation, Office of Medical Student Research, Tahlequah, OK, USA

  • Lauren Conway, DO, 

    Department of Paediatrics, University of Oklahoma, School of Community Medicine, Tulsa, OK, USA

  • Julie M. Croff, PhD, 

    Oklahoma State University Centre for Health Sciences, National Centre for Wellness and Recovery, Tulsa, OK, USA

J Osteopath Med; 123(7): 357-366
Abstract

Context: Many studies have shown increases in negative social aspects in the United States that may increase the likelihood of a child experiencing adversity. These rising trends include household dysfunction, poor mental health and substance use, crime rates, and incarceration. Additionally, the pathway of adverse childhood experiences (ACEs) may also perpetuate intergenerational trauma.

Objectives: Given these increased trends, our objective was to determine the mean ACEs reported among adults by year of birth to assess trends of ACEs over time.

Methods: To assess ACEs trends in the United States, we utilized data from the 2020 Behavioral Risk Factor Surveillance System (BRFSS), a nationally representative survey. We summed individuals’ reported ACEs and then calculated the mean ACE score within age cohorts (in 1-year increments) by year of birth. We utilized an auto-regressive integrated moving average (ARIMA) model to forecast mean ACEs through 2030.

Results: Respondents to the ACEs module (n=116,378) represented 63,076,717 adults in the United States, with an average age cohort of 1715 individuals. The mean reported ACEs among individuals 80 years or older (born in or before 1940) was 0.79, while the highest mean ACEs (2.74) were reported among the cohort born in 1998—an average increase of 0.022 ACEs per year. The ARIMA model forecasted that individuals born in 2018 will, on average, surpass a cumulative of three ACEs.

Conclusions: Given the connection of ACEs to poor health outcomes and quality of life, this trend is alarming and provides evidence for the necessity of child maltreatment prevention. Multigenerational trauma-informed care and education are warranted for individuals with ACEs and may even prevent the cycle from recurring.

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