Adverse Childhood Experiences in Ohio

Photo by Annie Spratt on Unsplash
My colleague Christelle Khalaf led this work; you may find her at

ACEs are traumatic experiences in a person’s life occurring before the age of 18 that the person remembers as an adult. Evidence of ACEs’ impact on a variety of health risk behaviors is well documented in the medical literature. The risk of alcoholism, drug use, and smoking increases as the number of reported ACEs increases (Anda et al., 2002; Dube et al., 2003; Ford et al., 2011). In addition, abuse in childhood is associated with adult obesity which is one of the possible pathways that link ACEs to an increased risk of diabetes in adulthood (Williamson et al.,2002; Deschênes et al., 2018). ACEs impact a variety of health outcomes either directly or indirectly through their impact on health risk behaviors. Childhood traumatic stress defined as at least one ACE increases the likelihood of hospitalization with a diagnosed autoimmune disease, decades into adulthood (Dube et al., 2009). ACEs has been linked to an increase in the probability of asthma, cancer diagnosis, cardiovascular disease (CVD), chronic obstructive pulmonary disease (COPD), hypertension risk, ischemic heart disease (IHD), and liver disease (Anda et al., 2008, Bhan et al., 2014; Brown et al., 2013; Dong et al., 2003; Dong et al., 2004; Su et al., 2015a; Su el al., 2015b). Further, exposure to ACEs impacts mental health by increasing the risk of depression and the utilization rate of psychotropic medications (Anda et al, 2002). Beyond the health costs associated with ACEs, there are additional economic impacts in the form of absenteeism, violence victimization and perpetration, as well as other societal problems (Ports el al., 2016; Sheats et al., 2018).

To better understand how ACEs affect Ohio residents, this study estimates the prevalence of ACEs in the state and it examines the heterogeneity of ACEs prevalence geographically and across subsets of the population (race, income level, disability status, age). In addition, it estimates population attributable risk (PAR) for ACEs and a number of health behaviors and outcomes (Alcohol Use, Tobacco Use, Depression, Diabetes, COPD, Cardiovascular Disease, Asthma, Healthy weight).