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Adverse Childhood Experiences (ACEs)

Franciscan Health is committed to the ACEs initiative and engaging community partners across Indiana and Illinois. As a leader in this charge, we are working to increase awareness and action.


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About ACEs

What Are ACEs?

Adverse Childhood Experiences, often referred to as ACEs, are traumatic or stressful events that occur between the ages of 0 and 17 years.  ACEs include: 

  • Abuse: Physical, sexual, emotional abuse

  • Neglect: Physical, emotional neglect

  • Household Dysfunction: Unmanaged mental illness, incarcerated relative, domestic violence, substance abuse, divorce

“Children’s exposure to Adverse Childhood Experiences is the greatest unaddressed public health threat of our time.” 
- Robert W. Block, MD, FAAP, immediate past president of the American Academy of Pediatrics

ACE Study

The ACEs language and concept came out of a research study which connected certain Adverse Childhood Experiences to a variety of health implications. This study is one of the largest investigations of childhood abuse and neglect and looked at 17,000 people to observe emotional and social health and the connection to health outcomes. 

Why Do ACEs Matter?

An increased number of ACEs puts an individual at greater risk for negative health and social outcomes including, but not limited to:

  • Behavioral problems
  • Poor mental health
  • Increased rates of substance abuse
  • Increased risky behavior
  • Development of serious health concerns (heart disease, lung disease, diabetes, etc.)

How To Help

ACEs are not destiny; they present a risk factor similar to that of genetics or poor health behaviors. Positive experiences, support systems and healthy relationships help to build resiliency and counter the effects of ACEs. The more ACEs one has, the more support and healthy relationships they will need to reduce toxic stress and build resiliency. 

Things that can help to tip the scale toward more positive outcomes might include:

  • Physical activity
  • Good nutrition
  • Access to medical care, regular wellness appointments
  • Stress reduction and mindfulness 
  • Mental healthcare
  • Forming healthy connections and relationships 
  • Mentor or consistent support person

FAQs About ACEs

What counts as an ACE?

Adverse Childhood Experiences encompass forms of abuse, neglect, violence and trauma; they may also be community and environmentally-based.

  • Physical abuse
  • Domestic violence
  • Sexual abuse
  • Household substance abuse
  • Emotional abuse
  • Parental separation or divorce
  • Physical neglect
  • Incarcerated household member
  • Emotional neglect
  • Untreated mental illness

Community & Environmental Stressors

Research shows that certain community and environmental stressors also contribute to childhood trauma. 

  • Racism
  • Involvement with the foster care system
  • Bullying
  • Surviving and recovering from a severe accident
  • Watching a sibling being abused
  • Involvement with the juvenile justice system
  • Losing a caregiver
  • Community violence
  • Homelessness

What is an ACE score? 

Ranging from 1-10, an ACE score is a sum of the total number of adverse childhood experiences (ACEs) someone has before the age of 18. After the age of 18, your score does not change. 

What does an ACE score mean? 

ACE scores are not destiny, they are risk factors that can help in understanding an individual's potential for future adverse health and social outcomes. Most people have at least one ACE in their history. Having a higher number of ACEs is positively correlated to adverse health and social outcomes.The more ACEs one has, the higher the risk that they will have health challenges that could include things like diabetes, addiction, cancer, and even early death. 

What health consequences are linked to ACEs? 

  • Behavioral problems (suicidal ideation, depression, anxiety, trouble relating to people)
  • Poor mental health
  • Increased rates of substance abuse
  • Increased risky behavior, impulsivity 
  • Development of serious health concerns (heart disease, lung disease, diabetes, etc.)

What is toxic stress and how does it relate to ACEs? 

During an adverse childhood experience, the body's stress response is activated for a prolonged period of time, resulting in toxic stress. Toxic stress is an acute form of stress that results in physical damage to a child's brain development. 

What are some signs or clues that my child is experiencing toxic stress? 

Your child may be experiencing toxic stress if they demonstrate:

  • Sleep issues
  • Frequent headaches
  • Stomach aches
  • Crying more than usual
  • Clinginess
  • Bed wetting
  • Baby talk 
  • Development of fears

How can I foster resiliency in my child? 

Explore the 7Cs of resiliency here

In The News

Franciscan Health Partners With A Trauma-Informed Community Platform, ACEs Connection

Franciscan Health has partnered with an online community platform, ACEs Connection, to generate awareness, engagement, and discussion regarding childhood adversity.


Franciscan Health Partners With BroadStreet To Launch First National ACEs Data Dashboards

Franciscan Health has partnered with BroadStreet to create nationally available dashboards for ACEs Risk In Children. The ACEs Risk In Children dashboards will provide data that pertains to ACE (Adverse Childhood Experiences) for a selected location.


ACEs, Traumatic Experiencs Can Affect Your Health For Years To Come

"Research shows us that traumatic childhood events - what the medical community calls adverse childhood experiences, or ACEs, significantly increase a person's risk for developing a number of health problems, even decades after the trauma occurs." 



Broadstreet ACEs Dashboards for Indiana & Illinois

Children in Our Community

There are quite a few children of preschool and school-age in our community. They come from a variety of backgrounds including different household types and ethnic backgrounds.

Number of children under 18 years: 1,644,707

View full data at the Broadstreet Interactive Dashboard

Children Living in Poverty 

Poverty may bring stressful exposures into the lives of children. Research indicates that poverty is highly related with ACE exposure, and that children living in poverty are more likely to experience frequence and intense ACEs. Often, poverty is a catalyst for a lifetime of health problems. 

Children under 18 years living in poverty: 23% 

Children elegible for free and reduced price lunch: 62%. This is higher than the U.S. average of 49%

View full data at the Broadstreet Interactive Dashboard 

Children Living in Affluence and Deprivation

Throughout childhood, we are exposed to multiple risk factors (e.g., violence) as well as protective factors (e.g., safe neighborhoods). These exposures occur at multiple levels, including at the individual, family, peer group, school, neighborhood, and community level. This means that neighborhoods, where we live, can have a significant impact on health. One screening measure of exposures is the Area Deprivation Index (ADI), which ranks neighborhoods by greatest disadvantage according to socioeconomic status. 

Children under 18 years by Area Deprivation Index: Each dot represents 10 children. Red areas indicate the most deprived areas (aka, lower socioeconomic status). 

View full data at the Broadstreet Interactive Dashboard 

Parental Stress

The stress of a parent can impact a child's level of stress. Research indicates a link between children in low-income and single-parent households and child maltreatment (a type of ACE). 

Children under 18 years in poverty and single-parent households: Larger bubbles indicate a higher number of children who are living in poverty and within a single-parent household. 

View full data at the Broadstreet Interactive Dashboard 

Signs of Risk-Taking Behavior 

Adolescents who are victims of maltreatment are at significantly greater risk of engaging in behaviors that lead to negative health outcomes. Low educational attainment is an early sign of the effect of ACEs. 

Idle & disconnected youth (ages 16-19 years): These teenagers are not in school and not working. Darker blue colors indicate more teenagers who fall within this category. 

View full data at the Broadstreet Interactive Dashboard 

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