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Special Emphasis Report: Adverse Childhood Experiences

Adverse childhood experiences (ACEs) are potentially traumatic events or circumstances in childhood (0-17 years), including aspects of a child’s environment that can undermine their sense of safety, stability, and bonding. ACEs can negatively impact physical, mental, emotional, and behavioral development and can also have lasting effects on health, well-being, and prosperity well into adulthood.

Impact and Magnitude of ACEs

The effects of ACEs can be passed down from one generation to the next, especially when positive childhood experiences are not in place in a child's life. Positive childhood experiences can include being in a safe, stable, and nurturing environment and having community and family support. As of 2020-2021, 38.3% percent of children in Illinois have experienced one or more ACEs, and 15.5% percent have experienced two or more ACEs, as reported by a parent/caregiver. This is compared to the 38.8% of children who have experienced at least one ACE nationally.

Percentage of ACEs, 2020-2021

Number of ACEs Percentage of Children
2+ 15.5%
1 22.8%
0 61.7%

Types of ACEs

The most prevalent type of ACE experienced in Illinois was divorce or separation, impacting 21.1% percent of children. This was followed by financial troubles, impacting 13.7% of Illinois children.

Top Five Types of ACEs Experienced by Children, 2020-2021

Type of ACE** Percentage

1. Divorce or separation of parent/caregiver

21.1%

2. Financial troubles

13.7%

3. Co-resided with someone with a mental illness

6.7%

4. Lived with someone with a substance use disorder

6.4%

5. Parental or caregiver incarceration

5.3%

**All of the included ACEs, except discrimination, are experienced by someone in the child’s household. Discrimination is in regard to the child’s experience.

ACEs by Demographic

ACEs vary by individual and population level characteristics. ACEs in Illinois disproportionately impacted other non-Hispanic race/ethnicity.

Percentage of 2+ ACE(s) by Race/ Ethnicity, 2020-2021

Race/Ethnicity Percentage

Other, non-Hispanic

25.6%

Black, non-Hispanic

23.7%

Hispanic

18.4%

White, non-Hispanic

11.4%

Asian, non-Hispanic

7.6%

Positive Childhood Experiences

There are opportunities to improve the lives of children and adults. It starts with healthy childhoods, which can provide lasting benefits throughout life. In Illinois, 98.4% of children have a safe and supportive school environment and 96.4% experienced neighborhood safety.

Percentage of Positive Childhood Experiences, 2020-2021

Positive Childhood Experiences Percentage

School safety (ages 6-17)

98.4%

Neighborhood Safety

96.4%

Family Resilience

94.7%

No difficulty making/keeping friends (ages 6-17)

94.0%

Does not experience bullying (ages 6-17)

70.3%

Neighborhood Support

57.5%

School safety is identified from Indicator 7.3. Neighborhood safety is identified from Indicator 7.2. Family resilience is identified from Indicator 6.12. No difficulty making friends is identified from Indicator 2.6. Does not experience bullying is identified from Indicator 2.2. Neighborhood support is identified from Indicator 7.1.

Additional information about these indicators can be found at https://www.childhealthdata.org/browse/survey

CDC Resources to Support State and Local Strategies

ACEs Prevention Strategies

The primary prevention of ACEs—stopping ACEs before they start—would result in fewer risks for unintentional and intentional injuries, reduction of poor health conditions, and less pressure on healthcare systems.

Six Strategies for Preventing ACEs

  1. Strengthen economic supports for families (e.g., earned income tax credits, family-friendly work policies).
  2. Promote social norms that protect against violence and adversity (e.g., public education campaigns and bystander approaches to support healthy relationship behaviors).
  3. Ensure a strong start for children (e.g., early childhood home visitation, high quality/affordable childcare, preschool enrichment programs).
  4. Enhance skills to help parents and youths handle stress, manage emotions, and tackle everyday challenges
  5. Connect children to caring adults and activities (e.g., social emotional learning, safe dating/healthy relationship, and parenting/family relationship programs).
  6. Intervene to lessen immediate and long-term harms (e.g., enhanced primary care to address ACEs exposures and advancement of trauma-informed care for people with a history of exposure to ACEs). While not a primary prevention strategy, timely access to assessment, intervention, support, and treatment for children who have experienced ACEs can help mitigate the consequences of ACEs.

ACEs Activities in Illinois

The Illinois Department of Public Health (IDPH) Violence and Injury Prevention Section (VIPS) was awarded the State Injury Prevention Project (SIPP) grant from the CDC to support the advancement of the state strategic plan to prevent injury, violence, and suicide. SIPP will enhance the VIPS capacity to engage in robust surveillance and to strengthen strategic partnerships for public health action with an emphasis on the following priority areas: ACEs, traumatic brain injury, and transportation safety. VIPS is collecting and analyzing ACEs-related data and is aligning the work with the Illinois ACEs Response Collaborative’s Data Workgroup goals.

IDPH's Maternal Child Health (MCH) ACEs program, funded by federal Title V funding, focuses on advancing efforts to prevent, to mitigate, and to treat childhood adversity and trauma through an equity lens. Two key partners currently immersed in ACEs will be engaged – Prevent Child Abuse Illinois to focus on activities targeting the general public and community organizations and Health and Medicine Policy Research Group to focus on activities targeting health professionals/providers.

The Prevent Child Abuse Illinois ACEs Project is funded by IDPH's MCH ACEs Grant Program. The goal of the ACEs project is to address the impact of ACEs through a statewide environmental scan, a public awareness campaign, and by engaging partners across the state through the ACEs network. To learn more about Prevent Child Abuse Illinois and the ACEs project, visit www.preventchildabuseillinois.org and www.happychildhoods.info.

The Illinois ACEs Response Collaborative, a program of the Health and Medicine Policy Research Group, is a cross- sector movement to prevent trauma, promote thriving across the lifespan, and place the impact of childhood experience at the forefront of the state’s equity agenda. The collaborative leads policy initiatives, trains organizations and professionals in trauma-informed approaches, and disseminates research and resources.

The Illinois Children’s Mental Health Partnership (ICMHP) is a statewide public/private partnership created by the Children’s Mental Health Act to develop a plan to build a comprehensive and coordinated mental health system to better address the needs of children, adolescents, and their families. ICMHP has made significant progress in improving children’s mental health through collective efforts, such as reducing sigma, numerous educational publications, identification of service descriptors, early childhood mental health consultation, implementation of the Illinois Social and Emotional Standards, statewide expansion of the Screening Assessment and Support Services (SASS) Program, and community-based linkage to services. Learn more at https://www.icmhp.org.

The Illinois Childhood Trauma Coalition (ICTC) is made up of more than 120 public, private, clinical, research, advocacy, and educational institutions. The ICTC promotes research and develops communications designed to raise awareness about childhood trauma throughout the state. As part of the communications efforts, ICTC instituted a statewide public media campaign to help families become more aware that childhood trauma exists. Learn more at www.theictc.org.