By Carol Hopp | If you had the opportunity to make a difference in the future health and behavioral outcomes of children in your community, would you? Of course! That is why understanding the ACE Study is so important. It shows how experiencing trauma as a child can lead to behavioral and health issues as an adult. With this knowledge, you can recognize, respond, or even prevent a possible traumatic situation, making a difference for your child and their friends. The ACE (Adverse Childhood Experiences) Study used a brief ten-question survey to ask participants about childhood emotional and physical abuse and neglect, sexual abuse, and household dysfunction that included violence, substance abuse, mental illness, parental separation or divorce, and incarcerated household members.

Based on survey responses, participants were given an ACE score that ranged from 0 to 10 , 0 representing no trauma and 10 representing multiple adverse childhood experiences. The study found that the higher the ACE score, the greater the risk for future health issues (COPD, depression, heart disease, liver disease, sexually transmitted diseases, adolescent pregnancy, quality of life) and behavioral problems (alcoholism, illicit drug use, smoking, and intimate partner violence).

When Iowa conducted their own study in 2012, the trend continued. As ACE scores increased, one’s chance of partaking in high risk behaviors and of being diagnosed with a serious physical or mental health condition increased.  According to the 2012 Iowa Behavioral Risk Factor Surveillance System (BRFSS), over half of the adult population in Iowa reported having at least one ACE.  The following reflects the percentages of the county populations in our service area with ACE scores of 2 or more:

  • 28% – Howard
  • 30% – Winneshiek
  • 42% – Fayette
  • 21% – Allamakee
  • 34% – Delaware
  • 23% – Dubuque

ACEs Prevalence

ACEs can affect every aspect of our lives, including how we raise our children. On average 5 out of every 30 students in an Iowa classroom have a parent with a very high ACE score (4 or more). If we never recover from trauma we experience as children, research shows we are more likely to have behavioral problems such as substance use and risky decision-making that will cause our children to have adverse childhood experiences as well.

So what can you do to prevent trauma from further impacting kids? You can help build foundations of healthy development for children and be trauma-informed. First, provide your child with a stable and caring relationship, safe and supportive environments, and appropriate nutrition. Next, utilize the services of local organizations that support families and promote healthy child development. Lastly, make informed decisions when implementing or reviewing policy or practice changes at your child’s school or in your local government that can help reduce the impact of ACEs on public health. You can use your new knowledge of ACEs to ask how a policy or practice change will promote healthy child development and how it will enhance the ability of everyone to prevent or reduce the negative effects of adverse childhood experiences.

The other way to protect our kids involves being trauma-informed, realizing that childhood trauma or ACEs could have had an impact on an adult’s current health or behaviors. So the next time you are frustrated with an unhealthy decision someone in your life is making, take a minute to think about the underlying reasons for the choice; it may be a coping mechanism they established in their younger years to deal with stress from adverse experiences. I encourage you to better understand ACEs, to help create environments where children feel emotionally and physically safe, and to remember that ACEs are common. To find out more about ACEs or to be a part of your county’s coalition, working to reduce substance abuse, a common result of ACEs,  contact the Substance Abuse Prevention Team at


This post originally was published on this blog Dec 5, 2014  and was updated Apr 17. 2015.

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