Skip directly to searchSkip directly to the site navigationSkip directly to the page's main content

Complete Health Indicator Report of Adverse Childhood Experiences (ACEs)

Definition

Childhood experiences, both positive and negative, have a tremendous impact on future violence victimization and perpetration, and lifelong health and opportunity. The ACEs included here are a collection of common experiences that may be traumatic to children and youth. They include abuse, neglect, and household challenges that occur during the first 18 years of life. ACEs have been shown to have a potential impact on future violence, victimization, and perpetration, as well as lifelong health and opportunity. ACEs are common; as nearly two-thirds (61.6%) of surveyed U.S. adults experienced at least one ACE and many adults experienced more than one. ACEs can affect optimal health and development across the lifespan, particularly in the absence of protective factors. However, ACEs are preventable, and when present their effects can be mitigated.

Numerator

The 2013, 2016, 2018, and 2020 BRFSS respondents who responded affirmatively to the eleven questions in the Adverse Childhood Experience (ACE) Module.

Denominator

The number of adults aged 18 and above who participated in the 2013, 2016, 2018, and 2020 BRFSS.

Data Interpretation Issues

BRFSS Adverse Childhood Experience (ACE) Module Looking back before you were 18 years of age---. 1) Did you live with anyone who was depressed, mentally ill, or suicidal? 2) Did you live with anyone who was a problem drinker or alcoholic? 3) Did you live with anyone who used illegal street drugs or who abused prescription medications? 4) Did you live with anyone who served time or was sentenced to serve time in a prison, jail, or other correctional facility? 5) Were your parents separated or divorced? 6) How often did your parents or adults in your home ever slap, hit, kick, punch or beat each other up? 7) Before age 18, how often did a parent or adult in your home ever hit, beat, kick, or physically hurt you in any way? Do not include spanking. 8) How often did a parent or adult in your home ever swear at you, insult you, or put you down? 9) How often did anyone at least 5 years older than you or an adult, ever touch you sexually? 10) How often did anyone at least 5 years older than you or an adult, try to make you touch sexually? 11) How often did anyone at least 5 years older than you or an adult, force you to have sex? Module Weaknesses: Limited to specific more common adversities; Severity or frequency of potential trauma is unknown; All experiences are weighted equally; Module does not account for protective factors in the past that might prevent or mitigate the negative long-term impacts of childhood adversities.

Why Is This Important?

Exposure to ACEs may result in toxic stress responses that can impede a child's development, such as changes in gene expression, changes in brain connectivity and immune function, and changes in the type of coping strategies adopted. While many coping strategies are healthy and help reduce acute stress, some (e.g. smoking cigarettes, drinking alcohol, using substances, engaging in risky sexual behavior) present additional risks to health and wellbeing. As such, exposure to early adversity can increase the risk of later chronic and infectious health conditions through changes in physiological mechanisms, as well as increased engagement in health risk behaviors, and can ultimately result in premature death.

Available Services

The Violence and Injury Prevention Program housed in the Utah Department of Health in coordination with the Utah Coalition for Protecting Childhood (UCPC) has developed a State Action Plan for the Primary Prevention of Child Maltreatment in Utah utilizing the CDC's Essentials for Childhood framework. This plan includes specific strategies and approaches to preventing ACEs and mitigating their negative effects by creating safe, stable, and nurturing relationships and environments for all Utah children. The state plan can be found at vipp.health.utah.gov This is also a sensitive topic and if you need information or help finding support for your own experiences you can dial 1-800-422-4453.


Related Indicators

Relevant Population Characteristics

As the number of ACEs increases so does the risk of injury, sexually transmitted infections (including HIV), mental health problems, maternal and child health problems, teen pregnancy, involvement in sex trafficking, a wide range of chronic diseases, and dying from one of the leading causes of death (such as cancer, diabetes, heart disease, and suicide). ACEs can also negatively impact education, employment, and earnings potential.

Related Relevant Population Characteristics Indicators:




Graphical Data Views

Adverse Childhood Experiences (ACEs) Prevalence by Type, Utah vs USA 2013, 2016, 2018, 2020

::chart - missing::
confidence limits

The most common ACE experienced by adults in Utah was emotional abuse with 38.3% indicating a parent or adult in the home had sworn at them, insulted them, or put them down before the age of 18. The next most prevalent ACEs in Utah are household substance abuse reported by 23.8% of adults and household mental illness reported by 23.7% of adults. Compared with national respondents, Utahns had a higher prevalence of Household Mental Illness (23.7% vs 16.5% nationally), Sexual Abuse (13.9% vs 11.6% nationally), Emotional Abuse (38.3 vs 34.4% nationally), and Physical Abuse (21.4% vs 17.9% nationally). Nationally, there are a higher prevalence of Divorce (27.6% vs 22.8% in Utah), Household Substance Abuse (27.6% vs 23.8% in Utah) and Domestic Violence (17.5% vs 15.7% in Utah).
Utah vs. U.S.Lower LimitUpper LimitNumer- atorDenom- inator
Record Count: 16
UtahEmotional Abuse38.3%37.5%39.2%8,88223,361
UtahHousehold Substance Misuse23.8%23.0%24.5%5,48823,361
UtahHousehold Mental Illness23.7%23.0%24.4%5,22323,361
UtahParental Separation/Divorce22.8%22.1%23.6%4,93123,361
UtahPhysical Abuse21.4%20.7%22.1%5,08423,361
UtahWitnessed Domestic Violence15.7%15.1%16.3%3,44523,361
UtahSexual Abuse13.9%13.3%14.5%3,28423,361
UtahIncarcerated Household Member8.0%7.5%8.5%1,60823,361
U.S.Emotional Abuse34.4%33.8%35.0%214,157
U.S.Household Substance Misuse27.6%27.0%28.1%214,157
U.S.Household Mental Illness16.5%16.0%17.0%214,157
U.S.Parental Separation/Divorce27.6%27.0%28.2%214,157
U.S.Physical Abuse17.9%17.4%18.5%214,157
U.S.Witnessed Domestic Violence17.5%17.0%18.0%214,157
U.S.Sexual Abuse11.6%11.3%11.9%214,157
U.S.Incarcerated Household Member7.9%7.4%8.4%214,157

Data Notes

All questions refer to the time period before respondents were 18 years of age.   Source of national data: Merrick, M.T., Ford, D.C., Ports, K. A., Guinn, A. S. (2018). Prevalence of Adverse Childhood Experiences From the 2011-2014 Behavioral Risk Factor Surveillance System in 23 States. JAMA Pediatrics, 172(11), 1038-1044.

Data Sources

  • Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health
  • U.S. Data: Behavioral Risk Factor Surveillance System (BRFSS), Division of Behavioral Surveillance, CDC Office of Surveillance, Epidemiology, and Laboratory Services


Adverse Childhood Experiences (ACEs) Prevalence by Score, Utah 2013, 2016, 2018, 2020

::chart - missing::
confidence limits

In Utah, 63% of adults have experienced at least one ACE, and over one in four have experienced three or more. Among Utah women, 28.1% experienced three or more ACEs compared with 23.3% of men, a statistically significant difference. Females affirmed experiencing more household substance abuse, house mental illness, domestic violence, divorce, and emotional abuse. Also, females were two times more likely to affirm experiencing sexual abuse than males. Males affirmed experiencing more physical abuse and incarcerated household members.
Males vs. FemalesLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 15
Male037.9%36.7%39.1%4,35810,998
Male123.7%22.7%24.7%2,70810,998
Male215.1%14.3%16.1%1,63610,998
Male39.2%8.5%10.0%93110,998
Male4+14.1%13.2%15.0%1,36510,998
Female036.1%35.0%37.3%4,89212,345
Female122.4%21.4%23.4%2,75012,345
Female213.4%12.6%14.3%1,61112,345
Female39.2%8.5%9.9%1,07212,345
Female4+18.9%18.0%19.9%2,02012,345
Total037.0%36.2%37.9%9,26123,361
Total123.0%22.3%23.7%5,45923,361
Total214.3%13.7%14.9%3,24923,361
Total39.2%8.7%9.7%2,00623,361
Total4+16.5%15.8%17.2%3,38623,361

Data Notes

All questions refer to the time period before respondents were 18 years of age.

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Adverse Childhood Experiences (ACEs) Prevalence by Disability, Type, Utah 2016, 2018, 2020

::chart - missing::

Compared to those with no disabilities, individuals with one or more disabilities indicated a statistically higher prevalence of experiencing all eight of the surveyed ACEs with sexual abuse being more than two times more prevalent (26% vs 12.2%).
One or more disabilities vs No disabilities
Record Count: 16
One or More DisabilitesEmotional Abuse51.2%
One or More DisabilitesHousehold Substance Misuse33.9%
One or More DisabilitesHousehold Mental Illness37.0%
One or More DisabilitesParental Separation/Divorce30.9%
One or More DisabilitesPhysical Abuse34.3%
One or More DisabilitesWitnessed Domestic Violence24.9%
One or More DisabilitesSexual Abuse26.0%
One or More DisabilitesIncarcerated Household Member12.9%
No DisabilitiesEmotional Abuse36.5%
No DisabilitiesHousehold Substance Misuse21.3%
No DisabilitiesHousehold Mental Illness21.5%
No DisabilitiesParental Separation/Divorce20.5%
No DisabilitiesPhysical Abuse19.0%
No DisabilitiesWitnessed Domestic Violence14.0%
No DisabilitiesSexual Abuse12.2%
No DisabilitiesIncarcerated Household Member7.2%

Data Notes

All questions refer to the time period before respondents were 18 years of age.


High ACE Score (4+ACEs) by Local Health District (LHD), Utah 2013, 2016, 2018, 2020

::chart - missing::
confidence limits

When comparing the impact of high ACE scores (4+ ACEs) by population density (Urban, Rural, Frontier), there is not a significant difference in the distribution. However, there are Local Health Districts (LHDs) that are significantly impacted by higher or lower prevalence than the state overall. LHDs with a statistically higher prevalence of high ACE scores (4+ ACEs) include Salt Lake County, Tooele County, and Weber-Morgan. LHDs with statistically lower prevalence of high ACE scores include Bear River, Summit County, Utah County, and Wasatch County.
Local Health DistrictLower LimitUpper LimitNoteNumer- ator
Record Count: 14
Bear River13.5%11.5%15.9%significantly lower than state175
Central13.9%10.7%17.9%137
Davis County15.4%13.6%17.3%322
Salt Lake County18.2%17.0%19.5%significantly higher than state1,071
San Juan12.4%7.9%19.0%34
Southeast18.6%14.6%23.3%117
Southwest16.6%14.2%19.3%212
Summit9.9%7.3%13.2%significantly lower than state61
Tooele23.0%19.1%27.4%significantly higher than state185
TriCounty17.4%14.6%20.6%194
Utah County13.5%12.1%15.0%significantly lower than state447
Wasatch11.1%7.5%16.1%significantly lower than state68
Weber-Morgan19.4%17.3%21.8%significantly higher than state333
State of Utah16.5%15.8%17.2%3,386

Data Notes

All questions refer to the time period before respondents were 18 years of age.   The 4+ ACE score is highlighted here because research suggests a higher prevalence of negative long-term impacts with higher ACE scores.

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


High ACE Score (4+ACEs) by Utah Small Area, Utah 2013, 2016, 2018, 2020

::chart - missing::
confidence limits

In order to facilitate data reporting at the community level, Utah has been divided into 99 Small Areas. These areas are determined based on specific criteria, including population size, political boundaries of cities and towns, and economic similarity. When comparing Utah Small Areas by population density (Urban, Rural, Frontier), there is not a significant difference in the distribution of ACEs. However, there are Utah Small Areas that are significantly impacted by more ACEs or fewer ACEs than the state as a whole. Utah Small Areas with statistically higher prevalence of high ACE scores (4+ ACEs) include Tooele County (Other), South Salt Lake, Taylorsville (West), Magna, Taylorsville (East)/Murray (West), Kearns V2, Murray, Sandy (West), Ogden (Downtown), Riverdale, West Vally (East) V2, and Layton/South. Utah Small Areas with a statistically lower prevalence of high ACE scores include Hurrican/La Verkin, Alpine, Woods Cross/West Bountiful. North Salt Lake, Delta/Fillmore, Draper, North Logan, Orem (West), Spanish Fork, Summit County (East), West Jordan (West)/Copperton, Park City, and Wasatch County
Utah Small AreasLower LimitUpper LimitNoteNumer- ator
Record Count: 100
Brigham City17.5%11.4%25.9%25
Box Elder Co (Other) V220.2%11.6%32.6%19
Tremonton11.9%6.7%20.2%* interpret w/caution15
Logan V214.8%11.1%19.5%58
North Logan8.4%4.9%14.0%significantly lower than state19
Cache (Other)/Rich (All) V212.7%7.9%19.9%21
Hyrum10.6%4.8%21.9%* interpret w/caution6
Smithfield13.3%6.6%25.1%* interpret w/caution9
Ben Lomond18.7%14.6%23.8%71
Weber County (East)11.9%8.3%16.8%38
Morgan County17.8%10.2%29.1%* interpret w/caution14
Ogden (Downtown)24.2%18.5%31.1%significantly higher than state58
South Ogden21.3%15.8%28.2%51
Roy/Hooper19.7%15.0%25.3%59
Riverdale24.0%17.3%32.3%significantly higher than state37
Clearfield Area/Hooper14.5%10.9%18.9%57
Layton/South Weber21.7%17.7%26.3%significantly higher than state103
Kaysville/Fruit Heights12.5%8.3%18.3%31
Syracuse17.8%11.7%26.1%28
Centerville15.4%8.8%25.5%14
Farmington16.1%8.3%28.8%18
North Salt Lake7.4%4.1%13.2%* interpret w/caution, significantly lower than state12
Woods Cross/West Bountiful7.1%3.7%13.4%* interpret w/caution, significantly lower than state10
Bountiful12.0%8.5%16.7%43
SLC (Rose Park)15.7%10.4%23.1%28
SLC (Avenues)14.3%8.8%22.4%20
SLC (Foothill/East Bench)12.7%7.2%21.5%20
Magna25.4%16.9%36.3%significantly higher than state28
SLC (Glendale) V221.5%14.0%31.4%25
West Valley (Center)17.7%12.8%24.1%50
West Valley (West) V213.4%8.6%20.4%24
West Valley (East) V221.9%16.6%28.3%significantly higher than state60
SLC (Downtown) V222.2%15.9%30.1%45
SLC (Southeast Liberty)15.6%10.0%23.3%25
South Salt Lake33.0%24.7%42.4%significantly higher than state45
SLC (Sugar House)22.8%15.8%31.8%38
Millcreek (South)10.9%5.6%20.2%* interpret w/caution13
Millcreek (East)18.8%11.7%29.0%23
Holladay V213.2%7.4%22.3%18
Cottonwood15.0%10.3%21.3%40
Kearns V224.7%18.4%32.3%significantly higher than state49
Taylorsville (E)/Murray (W)24.7%18.0%32.8%significantly higher than state41
Taylorsville (West)27.6%20.7%35.8%significantly higher than state44
Murray24.5%17.8%32.8%significantly higher than state43
Midvale17.8%12.0%25.7%28
West Jordan (Northeast) V222.5%15.4%31.7%significantly lower than state32
West Jordan (Southeast)17.3%11.9%24.4%34
West Jordan (W)/Copperton10.5%7.0%15.6%28
South Jordan V212.0%8.0%17.5%28
Daybreak19.9%12.5%30.2%20
Sandy (West)24.4%16.6%34.4%significantly higher than state31
Sandy (Center) V220.2%12.9%30.1%24
Sandy (Northeast)11.2%5.6%21.3%* interpret w/caution13
Sandy (Southeast)13.7%8.4%21.6%21
Draper8.1%5.0%12.9%significantly lower than state23
Riverton/Bluffdale18.8%13.1%26.2%42
Herriman13.1%9.0%18.8%35
Tooele County (Other)35.7%25.6%47.2%significantly higher than state45
Tooele Valley19.3%15.7%23.5%136
Eagle Mountain/Cedar Valley16.2%9.8%25.7%21
Lehi14.0%10.1%19.2%51
Saratoga Springs10.6%6.3%17.3%18
American Fork12.5%8.3%18.4%32
Alpine4.9%2.0%11.9%* interpret w/caution, significantly lower than state5
Pleasant Grove/Lindon16.7%11.5%23.8%38
Orem (North)19.9%14.0%27.4%37
Orem (West)9.0%5.7%14.1%significantly lower than state23
Orem (East)18.0%11.5%27.0%24
Provo/BYU12.7%7.9%19.7%24
Provo (West City Center)18.2%12.6%25.6%32
Provo (East City Center)11.9%6.6%20.7%19
Salem City13.5%6.9%24.7%* interpret w/caution10
Spanish Fork9.2%5.7%14.6%significantly lower than state22
Springville18.7%12.9%26.2%37
Mapleton**** suppressed
Utah County (South) V212.7%6.5%23.4%* interpret w/caution9
Payson13.4%8.8%20.1%25
Park City11.1%7.4%16.2%significantly lower than state35
Summit County (East)9.9%6.2%15.3%significantly lower than state26
Wasatch County11.1%7.5%16.1%significantly lower than state68
Daggett and Uintah County16.8%13.3%20.9%122
Duchesne County18.2%14.0%23.5%72
Nephi/Mona9.1%4.1%18.8%* interpret w/caution9
Delta/Fillmore7.5%4.0%13.6%significantly lower than state14
Sanpete Valley15.7%10.7%22.5%40
Central (Other)13.0%7.4%21.8%* interpret w/caution36
Richfield/Monroe/Salina19.0%12.1%28.4%34
Carbon County21.6%15.7%28.8%65
Emery County16.1%10.6%23.7%33
Grand County16.1%8.6%28.0%19
Blanding/Monticello10.7%6.4%17.3%22
San Juan County (Other)14.2%6.8%27.2%12
St. George16.0%12.4%20.4%74
Washington Co (Other) V213.7%5.8%29.1%* interpret w/caution9
Washington City23.5%16.0%33.1%26
Hurricane/La Verkin7.5%3.9%14.1%* interpret w/caution, significantly lower than state12
Ivins/Santa Clara18.9%10.6%31.4%14
Cedar City16.2%11.5%22.3%39
Southwest LHD (Other)17.9%12.0%26.0%34
State of Utah16.5%15.8%17.2%3,386

Data Notes

All questions refer to the time period before respondents were 18 years of age.   The 4+ ACE score is highlighted here because research suggests a higher prevalence of negative long-term impacts with higher ACE scores. Utah Small Areas. Retrieved on 10/25/2021 from Utah Department of Health, Center for Health Data and Informatics, Indicator-Based Information System for Public Health website: https://ibis.health.utah.gov/ibisph-view/pdf/resource/UtahSmallAreaInfo.pdf.

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


High ACE Score (4+ACEs) Prevalence by Income, Utah 2013, 2016, 2018, 2020

::chart - missing::
confidence limits

ACEs are common across all sociodemographic characteristics, yet some populations are more vulnerable to experiencing ACEs, such as children living in poverty and racial and ethnic minorities, because of the structural and social conditions in which some children and families live, learn, work, and play. Lower-income households are impacted with significantly more ACEs than the state as a whole, 24.8% of households making less than $25,000 affirmed 4+ ACEs. Households in extreme poverty (less than 50% of the poverty level) are even more impacted with 29.3% having 4+. This is more than two times the prevalence of 4+ ACEs experienced by households making more than $75,000.
Income CategoryLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 5
<$25,00024.8%22.7%27.0%7033,386
$25,000-$49,99917.9%16.4%19.6%6983,386
$50,000-$74,99916.5%14.8%18.3%5423,386
$75,000+14.0%13.0%15.0%1,0953,386
Total16.5%15.8%17.2%3,3863,386

Data Notes

All questions refer to the time period before respondents were 18 years of age.   The 4+ ACE score is highlighted here because research suggests a higher prevalence of negative long-term impacts with higher ACE scores.

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


High ACE Score (4+ACEs) Prevalence by Race/Ethnicity, Utah 2013, 2016, 2018, 2020

::chart - missing::
confidence limits

ACEs are common across all sociodemographic characteristics, yet some populations are more vulnerable to experiencing ACEs, such as children living in poverty and racial and ethnic minorities, because of the structural and social conditions in which some children and families live, learn, work, and play. Adults who identify as American Indian or Alaska Native are impacted with the highest numbers of ACEs, 31.2% having 4+ ACEs (almost double the overall prevalence); followed by Multiracial at 23.2% and Black at 22.2%.
Race/EthnicityLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 8
American Indian, Alaskan Native31.2%22.9%40.9%643,386
Asian9.0%5.1%15.5%223,386
Black, African American22.2%14.3%32.9%373,386
Hispanic, Latino19.6%17.3%22.1%3523,386
Native Hawaiian, Pacific Islander14.4%9.4%21.5%243,386
White15.8%15.1%16.5%2,8133,386
Two or More Races23.2%16.1%32.3%383,386
All Races/Ethnicities16.5%15.8%17.2%3,3863,386

Data Notes

All questions refer to the time period before respondents were 18 years of age.   The 4+ ACE score is highlighted here because research suggests a higher prevalence of negative long-term impacts with higher ACE scores.

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health

More Resources and Links

Evidence-based community health improvement ideas and interventions may be found at the following sites:

Additional indicator data by state and county may be found on these Websites:

Medical literature can be queried at the PubMed website.

Page Content Updated On 06/30/2022, Published on 07/07/2022
The information provided above is from the Department of Health's Center for Health Data IBIS-PH web site (http://ibis.health.state.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Sun, 02 October 2022 6:40:02 from Department of Health, Center for Health Data, Indicator-Based Information System for Public Health Web site: http://ibis.health.state.gov ".

Content updated: Thu, 7 Jul 2022 09:23:36 MDT