Prevalence of adverse childhood experiences among high school students: a cross-sectional analysis of 16 jurisdictions in the USA

BACKGROUND: Adverse childhood experiences (ACEs) are preventable, potentially traumatic events occurring before age 18, and are linked to numerous negative outcomes throughout life. Recent national studies report that ACEs are common among US high school students, but the prevalence of ACEs by state and local jurisdiction is unknown. The study objective was to estimate the prevalence of individual and cumulative ACEs among high school students in 16 US jurisdictions. METHODS: Using 2023 Youth Risk Behavior Survey data, we estimated the self-reported prevalence of eight individual (emotional, physical or sexual abuse; physical neglect; witnessed intimate partner violence; parental substance use problems; parental mental health problems; incarcerated or detained parent/guardian) and cumulative ACEs (0, 1, 2‒3, ≥4) among high school students <18 years in 16 US jurisdictions that included ACEs questions on their survey. RESULTS: Emotional abuse was the most reported ACE (range: 49.3%-64.0%) in all jurisdictions. In 13 of 16 jurisdictions, the other most common ACEs included physical abuse (20.8%-46.9%), parental mental health problems (23.6%-38.6%) and parental substance use problems (17.6%-33.1%). Jurisdiction-specific variation in the relative commonality and prevalence of individual and cumulative ACEs was present. DISCUSSION AND CONCLUSIONS: While some estimates overlapped, individual ACEs prevalence varied widely by site, highlighting the need for local data to inform prevention strategies. Local estimates can help decision makers understand communities' unique risks and strengths and evaluate progress towards preventing and mitigating ACEs using strategies from Centers for Disease Control and Prevention's Preventing Adverse Childhood Experiences Resource for Action.