National Center for Injury Prevention and Control adverse childhood experiences prevention strategy FY2021-FY2024
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National Center for Injury Prevention and Control adverse childhood experiences prevention strategy FY2021-FY2024

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      Safe, stable, nurturing relationships and environments are essential to children’s health and wellbeing. However, many children do not have these types of relationships or do not live in these types of environments, placing them at risk for adverse childhood experiences with the potential for immediate and long-term negative health and social impacts. While all children are at risk for adverse experiences, numerous studies have documented inequities in such experiences attributed to the historical, social, and economic environments in which some families live (Merrick et al., 2019).

      Adverse childhood experiences, or ACEs, are preventable, potentially traumatic events that occur in childhood (0-1 7 years) such as neglect, experiencing or witnessing violence, and having a family member attempt or die by suicide. Also included are aspects of a child’s environment that can undermine their sense of safety, stability, and bonding, such as growing up in a household with substance use; mental health problems; or instability due to parental separation or incarceration of a parent, sibling or other member of the household (Figure 1) (CDC, 2019; Felitti et al., 1998). Importantly, these examples do not comprise an exhaustive list of all childhood adversities, as there are other potentially traumatic experiences, such as bullying, experiencing racism, and the death of a parent,

      that can also impact health and wellbeing. Consideration of these forms of childhood trauma and their negative impact on health over time also supports the National Center for Injury Prevention and Control’s (Injury Center’s) strategic focus on the intersection of ACEs, suicide, and overdose as critical threats to public health that are interrelated and preventable (Hulsey et al., 2020; Pham, Porta, and Biernesser, 2018). In addition, conditions such as living in under-resourced or racially segregated neighborhoods, frequently moving, being subjected to homelessness, or experiencing food insecurity can be traumatic and exacerbate the effects of other ACEs. Finally, historical and ongoing traumas due to systemic racism and discrimination or the impacts of multigenerational poverty resulting from limited educational and economic opportunities intersect and exacerbate the experience of other ACEs, leading to disproportionate effects in certain populations (Nurious, Logan-Greene, and Green, 2012).

      Suggested citation: Centers for Disease Control and Prevention. Adverse Childhood Experiences Prevention Strategy. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 2021.



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