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Delaware Value:
Percentage of children ages 0-17 who have ever experienced two or more of the following: parental divorce or separation; living with someone who had an alcohol or drug problem; neighborhood violence victim or witness; living with someone who was mentally ill, suicidal or severely depressed; domestic violence witness; parent served jail time; being treated or judged unfairly due to race/ethnicity, sexual orientation or gender identity; or death of a parent (2-year estimate)
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Percentage of children ages 0-17 who have ever experienced two or more of the following: parental divorce or separation; living with someone who had an alcohol or drug problem; neighborhood violence victim or witness; living with someone who was mentally ill, suicidal or severely depressed; domestic violence witness; parent served jail time; being treated or judged unfairly due to race/ethnicity, sexual orientation or gender identity; or death of a parent (2-year estimate)
Percentage of children ages 0-17 who have ever experienced two or more of the following: parental divorce or separation; living with someone who had an alcohol or drug problem; neighborhood violence victim or witness; living with someone who was mentally ill, suicidal or severely depressed; domestic violence witness; parent served jail time; being treated or judged unfairly due to race/ethnicity, sexual orientation or gender identity; or death of a parent (2-year estimate)
US Value: 14.0%
Top State(s): New York: 9.8%
Bottom State(s): New Mexico: 24.7%
Definition: Percentage of children ages 0-17 who have ever experienced two or more of the following: parental divorce or separation; living with someone who had an alcohol or drug problem; neighborhood violence victim or witness; living with someone who was mentally ill, suicidal or severely depressed; domestic violence witness; parent served jail time; being treated or judged unfairly due to race/ethnicity, sexual orientation or gender identity; or death of a parent (2-year estimate)
Data Source and Years(s): National Survey of Children's Health, U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB), 2020-2021
Suggested Citation: America's Health Rankings analysis of National Survey of Children's Health, U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB), United Health Foundation, AmericasHealthRankings.org, accessed 2024.
Adverse childhood experiences (ACEs) are stressful or traumatic events that can impact children’s health and well-being throughout their lifespan. Early experiences have a broad and profound impact on an individual’s development and subsequent emotional, cognitive, social and biological functioning. The relationship between ACEs and health was first described in a study published in 1998, which found a higher number of adverse childhood exposures was associated with a higher number of risk factors for leading causes of death in adults. A recent study found that having four or more ACEs (compared with none) was associated with a number of adverse health outcomes, including:
There are also socioeconomic challenges associated with ACEs, including not graduating from high school, being unemployed and lacking health insurance. These negative experiences place a great economic burden on families, communities and society, costing an estimated $748 billion annually in North America.
The prevalence of ACEs is higher among:
Prevention strategies to address ACEs include:
Policy recommendations for addressing ACEs include:
The Centers for Disease Control and Prevention’s (CDC) Division of Violence Prevention has a free online training module on ACEs prevention. The introductory module is appropriate for anyone interested in learning about ACEs regardless of education level or profession and is designed to help users understand, recognize and prevent ACEs. Additional modules for professionals working directly with and on behalf of kids and families are also available.
Healthy People 2030 has a developmental objective to reduce the number of young adults ages 18-25 who report three or more ACEs.
Bellis, Mark A., Karen Hughes, Kat Ford, Gabriela Ramos Rodriguez, Dinesh Sethi, and Jonathon Passmore. “Life Course Health Consequences and Associated Annual Costs of Adverse Childhood Experiences across Europe and North America: A Systematic Review and Meta-Analysis.” The Lancet Public Health 4, no. 10 (October 1, 2019): e517–28. https://doi.org/10.1016/S2468-2667(19)30145-8.
Bethell, Christina D., M.B. Davis, Narangerel Gombojav, Scott Stumbo, and Kathleen Powers. “A National and Across-State Profile on Adverse Childhood Experiences Among U.S. Children and Possibilities to Heal and Thrive.” Issue Brief. Baltimore, MD: Johns Hopkins Bloomberg School of Public Health, October 2017. https://www.cahmi.org/docs/default-source/resources/issue-brief-a-national-and-across-state-profile-on-adverse-childhood-experiences-among-children-and-possibilities-to-heal-and-thrive-(2017).pdf.
Felitti, Vincent J., Robert F. Anda, Dale Nordenberg, David F. Williamson, Alison M. Spitz, Valerie Edwards, Mary P. Koss, and James S. Marks. “Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults.” American Journal of Preventive Medicine 14, no. 4 (May 1998): 245–58. https://doi.org/10.1016/S0749-3797(98)00017-8.
Hughes, Karen, Mark A. Bellis, Katherine A. Hardcastle, Dinesh Sethi, Alexander Butchart, Christopher Mikton, Lisa Jones, and Michael P. Dunne. “The Effect of Multiple Adverse Childhood Experiences on Health: A Systematic Review and Meta-Analysis.” The Lancet Public Health 2, no. 8 (August 2017): e356–66. https://doi.org/10.1016/s2468-2667(17)30118-4.
Merrick, Melissa T., Derek C. Ford, Katie A. Ports, Angie S. Guinn, Jieru Chen, Joanne Klevens, Marilyn Metzler, et al. “Vital Signs: Estimated Proportion of Adult Health Problems Attributable to Adverse Childhood Experiences and Implications for Prevention — 25 States, 2015–2017.” MMWR. Morbidity and Mortality Weekly Report 68, no. 44 (November 8, 2019): 999–1005. https://doi.org/10.15585/mmwr.mm6844e1.
America’s Health Rankings builds on the work of the United Health Foundation to draw attention to public health and better understand the health of various populations. Our platform provides relevant information that policymakers, public health officials, advocates and leaders can use to effect change in their communities.
We have developed detailed analyses on the health of key populations in the country, including women and children, seniors and those who have served in the U.S. Armed Forces, in addition to a deep dive into health disparities across the country.