Adverse Childhood Experiences (ACEs)

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Note: These publications were published in 2020 and 2021. For most-recent data, consult the data sources at the end of the publication.

 

 

Data Points

 

Health Impact of ACEs in Ohio

Key data findings

  • Nearly two-thirds of Ohioans have been exposed to ACEs. Ohioans of color and Ohioans with low incomes, disabilities and/or who are residents of urban and Appalachian counties are more likely to experience multiple ACEs.
  • Among Ohioans who reported exposure to at least one ACE, the most common type of ACE reported was emotional abuse (57%), followed by substance use by a household member (41%) and divorce (36%).
  • Preventing ACEs can improve health. For example, if exposure to ACEs were eliminated among Ohioans, an estimated 36% of depression diagnoses could be prevented.
  • Focusing action on specific ACEs may yield more significant health impacts. For example, if adequate supports and policies were in place to prevent parental or other household member incarceration, an estimated 7% of current smoking and 12% of limited healthcare access due to cost could also be eliminated.

Suggested citation: Health Policy Institute of Ohio. "Adverse Childhood Experiences (ACEs): Health Impact of ACEs in Ohio," August 2020.

 

Economic Impact of ACEs in Ohio

Key data findings

  • Preventing ACEs can reduce healthcare and other spending. If ACEs exposure were eliminated, more than $10 billion in annual healthcare and related spending could be avoided in Ohio.
  • Approximately $319 million in lost wages due to missed work days could also be prevented annually if ACEs exposure were eliminated.
  • Focusing action on specific ACEs, particularly those associated with behavioral health, can yield significant savings. For example, over $4.5 billion in annual spending to treat depression is attributed to ACEs exposure. Significant healthcare costs for treating depression could be avoided by focusing on preventing and mitigating the impacts of abuse.

Suggested citation: “Adverse Childhood Experiences (ACEs): Economic Impact of ACEs in Ohio,” Health Policy Institute of Ohio, 2021.  

 

A strategic approach to prevent ACEs in Ohio

Key data findings

  • Nearly two-thirds (61%) of Ohio adults reported exposure to ACEs during childhood.
  • Ohioans could save over $1 billion annually in public and private healthcare and related spending if just 10% of the cost attributable to ACEs exposure were avoided.
  • Ohioans who reported experiencing multiple ACEs were also more likely to report poor health outcomes and behaviors — Ohioans of color and Ohioans with low income, disabilities and/or who live in urban and Appalachian counties are more likely to experience multiple ACEs.

Suggested citation: “Adverse Childhood Experiences (ACEs): A strategic approach to prevent ACEs in Ohio,” Health Policy Institute of Ohio, 2021.  

 

Ensuring a strong start for children and strengthening economic supports for families

Key data findings

  • Early childhood education programs have been found to prevent and mitigate ACEs, such as mental illness in the home, and have strong evidence of return on investment, with an estimated cost-benefit ratio of $3.15.
  • Research indicates that family income in early childhood is a predictor of health outcomes later in life and that childhood poverty is linked to diminished educational and employment opportunities across the life course.
  • As of February 2022, there was at least one early childhood home visiting provider in every Ohio county using a model identified as “evidence-based” by the U.S. Department of Health and Human Services Home Visiting Evidence of Effectiveness (HomVEE) review.
  • Medical-legal partnerships impact ACES by reducing stress and improving the well-being of children and their families and have a cost-benefit ratio of $6.98.
  • Family income supports reduce poverty and increase employment, among other outcomes. Supports may also address many of the physical, social and economic conditions (e.g., limited economic resources, low educational attainment, poor mental health) that contribute to ACEs and the generational impacts of ACEs.

Suggested citation: “Strategies to prevent Adverse Childhood Experiences (ACEs) in Ohio: Ensuring a strong start for children and strengthening economic supports for families,” Health Policy Institute of Ohio, 2021.  

 

Building skills and strengthening connections to caring adults

Key data findings

  • There are many opportunities to support partners across the state who are implementing cost-effective, evidence-informed strategies to prevent and mitigate ACEs.
  • There are variety of evidence-informed strategies and resources available to buffer children and families from the well-documented harmful effects of ACEs.
  • ACEs prevention efforts must meet the needs of more children and families. To maximize impact, strategies should be scaled up and tailored towards those most at risk for experiencing adversity.
  • In 2021, 88% of Ohio adults reported that during their childhood, they had an adult in their household that made them feel safe and protected all or most of the time. Having at least one nurturing, stable caregiver can mitigate the negative effects of ACEs.
  • Many Ohio high school students have experienced peer violence, bullying and intimate partner violence. For example, in 2021, 19% of students were bullied electronically and 20% were bullied on school property.

Suggested citation: “Strategies to prevent Adverse Childhood Experiences (ACEs) in Ohio: Building skills and strengthening connections to caring adults,” Health Policy Institute of Ohio, 2023.  

 

Promoting positive social norms and intervening to lessen harm

Key data findings

  • Over 5% of Ohioans overall reported that their child did not live in a safe neighborhood. Ohioans earning a wage 0-99% of the federal poverty level (FPL) and Black Ohioans were more likely to report this. Structural racism has resulted in concentrated disadvantage in segregated neighborhoods, which leads to higher levels of violent crime in these neighborhoods.
  • When compared to traditional case depositions, drug courts have been shown to significantly reduce recidivism (i.e., the likelihood that the person will commit another criminal offense after release from jail or prison) by 38-50%; 75% of drug court participants in the United States were not arrested for at least two years after leaving a program.
  • According to HPIO’s 2023 Health Value Dashboard, 25% of Ohio adults with mental illness reported needing mental health treatment or counseling within the past year and not receiving it. This was also true for 18.2% of Ohio children ages 3-17.

Suggested citation: “Strategies to prevent Adverse Childhood Experiences (ACEs) in Ohio: Promoting Positive Social Norms and Intervening to Lessen Harm,” Health Policy Institute of Ohio, 2024.  

 

Support for this project was provided by the Harmony Project, the Ohio Children’s Hospital Association and HPIO’s other core funders