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California PACEs Action

New report on California ACEs prevalence shines light on racism and disparities


Racism is among the root causes of adverse childhood experiences, according to a newly released report on the prevalence of ACEs in California.

“Children of color are disproportionately impacted by ACEs due to stressful environments, socio-economic inequalities, and lack of systemic support and resources for families of color,” the report said. Released by the Essentials for Childhood Initiative, the report reflects state data from the Behavioral Risk Factor Surveillance System between 2011 and 2017.

“Adverse childhood experiences” is a term that comes from the landmark Centers for Disease Control and Prevention/ Kaiser Permanente ACE Study of more than 17,000 adults. It linked ACEs to the adult onset of many chronic diseases, mental illness, violence and becoming a victim of violence.

The ACE study also found that ACEs are remarkably common — most people have at least one. People who have four or more different types of ACEs — about 12% of the population — have a 1200% higher risk of attempting suicide and a 700% higher risk of becoming an alcoholic, compared with people who have no ACEs.

The epidemiology of childhood adversity, which produces ACE surveys, is one of five parts of ACEs science. The others are how toxic stress from ACEs affects children’s brains, the short- and long-term health effects of toxic stress, how toxic stress is passed on from generation to generation, and research on resilience, which includes how individuals, organizations, systems and communities can integrate ACEs science to solve our most intractable problems.

Black or Hispanic Californians were more likely to report 4 or more ACEs than state residents who identified as White or “other” in their responses to the BRFSS survey. Overall, 16% of the state’s residents reported an ACE score of 4 or more, and 62 % of all Californians had at least one ACE.

These figures are similar to the rest of the country. Survey respondents in 23 other states who identified as multiracial, Hispanic or Black experienced the highest exposure to adversity in childhood compared to respondents who described themselves as White or “other.”

The report also pinpointed geographically which counties experienced the burden of higher ACEs. Twenty-seven of California’s 58 counties, some 46 %, reported a prevalence of ACE scores of 4 or more that was higher than the state average prevalence of ACE scores of 4 or more. Humboldt, Trinity, San Benito and Kings counties in the north and center of the state reported the highest prevalence of 4 or more ACEs.

Compared to Californians who reported an ACE score of 0, residents who reported 4 or more ACEs were 3.5 times as likely to report mental distress, twice as likely to report poor health, and 3 times as likely to report not feeling well in the 14 days prior to answering the survey, according to the report.

Californians who received health insurance through the state’s Medicaid program, known as Medi-Cal, were more likely to report 4 or more ACEs (22.8%) than Californians with employer-based or private insurance (17%), Medicare (14.8%) or no insurance (18.6%), the report said. But for Californians who reported ACE scores between 1 and 3, the type of health care coverage was less significant: Medi-Cal 45.9 %; employer and private health 46.8%; Medicare or other 44.6%.

The most common ACEs reported by Californians looking back on their childhoods were emotional abuse (30.4%), living in a household where a family member abused alcohol or drugs (28.2%), and being the child of parents who were separated or divorced (27.9%)

Californians who lacked technical school training or didn’t attend college were also more likely to have higher ACE scores than fellow residents with more training and education. For example, more than 19% of high school graduates reported ACE scores of 4 or more compared to 12.9 % of Californians who graduated from college or technical school.

Unsurprisingly, a higher ACE score was also associated with lower household income levels. More than 20% of survey respondents from households earning less than $25,000 annually reported ACE scores of 4 or more. In contrast, just over 13% of residents earning more than $75,000 reported an ACE score of 4 or more. However, there was little difference in income among Californians who reported between 1 and 3 ACEs, averaging 45% to 46% at all income levels.

You can read the full report here.

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