Adverse childhood experiences and chronic health outcomes: evidence from 33 US states in the Behavioral Risk Factor Surveillance System, 2019-2023

High ACE scores are associated with chronic disease and mental health issues. These findings highlight significant racial and geographic disparities in ACE exposure and its health impacts. Addressing ACEs holistically by considering state-related factors and predisposed health risks among racial/ethnic groups is an emerging need. State-level policies focused on trauma prevention, particularly for vulnerable racial groups and high-risk geographic areas, may help implement interventions tailored to address the unique associations between ACEs and health outcomes in diverse populations.