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Original site: www.cdc.gov/violenceprevention/aces/ace-brfss.html | RestoredCDC.org is an independent project, not affiliated with CDC or any federal entity. Visit CDC.gov for free official information. Due to archival on January 6, 2025, recent outbreak data is unavailable. Videos are not restored. Access data.restoredcdc.org for restored data. Use of this site implies acceptance of this disclaimer.[More]About Us Report Bug Compare ContentSkip directly to site content Skip directly to searchEspañol | Other LanguagesHere's how you knowAn official website of the United States government Here's how you knowViolence PreventionCenters for Disease Control and Prevention. CDC twenty four seven. Saving Lives, Protecting People Violence PreventionSearchSubmitViolence PreventionViolence PreventionBehavioral Risk Factor Surveillance System ACE DataBehavioral Risk Factor Surveillance System ACE DataRelated PagesMany states are collecting information about adverse childhood experiences (ACEs) through the Behavioral Risk Factor Surveillance System (BRFSS). The BRFSS is an annual, state-based, random-digit-dial telephone survey that collects data from non-institutionalized U.S. adults regarding health conditions and risk factors. Since 2009, all 50 states and the District of Columbia have included ACE questions for at least one year on their survey.States Collecting BRFSS ACE Data by Year, 2009-20212021 Alabama, Arkansas, Iowa, Kansas, Maine, Mississippi, Nevada, New Hampshire, New Jersey, New York, North Dakota, Ohio, Oregon, South Carolina, Virginia, Wisconsin2020 Alabama, Arizona, California, District of Columbia, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Mississippi, Missouri, Montana, Nevada, New Jersey, North Dakota, Oklahoma, Rhode Island, South Carolina, South Dakota, Texas, Utah, Virginia, Wisconsin, Wyoming2019 Alabama, Delaware, Florida, Indiana, Iowa, Kansas, Michigan, Mississippi, Missouri, New Jersey, New Mexico, New York, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Virginia, West Virginia, Wisconsin2018 Arizona, Arkansas, Georgia, Idaho, Indiana, Iowa, Kentucky, Maryland, Nevada, New Jersey, Oklahoma, Oregon, South Carolina, South Dakota, Utah, Virginia, West Virginia, Wisconsin2017 California, Connecticut, Illinois, Iowa, Oregon, South Carolina, South Dakota, Tennessee, Virginia, Wisconsin2016 Arizona, Arkansas, Georgia, Hawaii, Iowa, Louisiana, Michigan, Nevada, New Hampshire, New York, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Utah, Virginia, Wisconsin2015 Alaska, California, Iowa, Kansas, Kentucky, Louisiana, Maryland, Nebraska, Nevada, New Hampshire, Ohio, Oregon, South Carolina, Tennessee, Texas, Wisconsin2014 Alaska, Arizona, Colorado, Florida, Iowa, Kansas, Louisiana, Nevada, North Carolina, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, West Virginia, Wisconsin2013 California, Iowa, Michigan, Oregon, Utah, Wisconsin2012 Iowa, North Carolina, Oklahoma, Tennessee, Wisconsin2011 California, Maine, Minnesota, Montana, Nebraska, Nevada, Oregon, Vermont, Washington, Wisconsin2010 District of Columbia, Florida, Hawaii, Maine, Nebraska, Nevada, Ohio, Pennsylvania, Utah, Vermont, Washington, Wisconsin2009 Arkansas, California, Louisiana, New Mexico, Tennessee, WashingtonOpen All Close AllBRFSS ACE ModuleThe BRFSS adverse childhood experiences (ACE) module was adapted from the original CDC-Kaiser ACE study and is used to collect information on child abuse and neglect and household challenges. The module is available in English and Spanish.The questionnaires are not copyrighted, and there are no fees for their use. If you include the ACE study questionnaires in your research, a copy of the subsequent article(s) is requested (send to dvpinquiries@cdc.gov). Please note that while the questions used in the optional ACEs Module are provided below, these are subject to change. Please see the BRFSS Questionnaires website for the most updated information regarding what questions BRFSS used in the optional ACEs Module Survey.* BRFSS ACE Module 2021 [103 KB, 1 Page]* BRFSS ACE Module 2009-2020 [224 KB, 1 Page]* BRFSS ACE Module 2009-2020 (Spanish) [43 KB, 1 Page]pdf iconData and StatisticsACEs are categorized into two groups on the BRFSS ACE module: abuse and household challenges. Each category is divided into multiple subcategories. Neglect items were not added to the BRFSS ACE module until 2019.States that have added the ACE module using their own resources are not required to report ACE data back to CDC BRFSS. To access states’ ACE data please contact each state’s BRFSS coordinator. A list of state coordinators can be found on the BRFSS state coordinators web page.ACEs DefinitionsAll ACE questions refer to the respondent’s first 18 years of life.* Abuse1+ Emotional abuse: A parent or other adult in your home ever swore at you, insulted you, or put you down.+ Physical abuse: A parent or other adult in your home ever hit, beat, kicked or physically hurt you.+ Sexual abuse: An adult or person at least 5 years older ever touched you in a sexual way, or tried to make you touch their body in a sexual way, or attempted to have sex with you.* Household Challenges+ Intimate partner violence:2 Parents or adults in home ever slapped, hit, kicked, punched or beat each other up.+ Substance abuse in the household: A household member was a problem drinker or alcoholic or used street drugs or abused prescription medications.+ Mental illness in the household: A household member was depressed or mentally ill or a household member attempted suicide.+ Parental separation or divorce: Parents were ever separated or divorced.+ Incarcerated household member: A household member went to prison.* Neglect3*+ Emotional neglect: An adult in the household never or very seldom made you feel safe and protected.+ Physical neglect: An adult in the household never or very seldom tried hard to make sure your basic needs were met.1 Abuse Questions were modified from the original CDC-Kaiser ACE Study to make them more appropriate for a telephone survey.2 In the original CDC-Kaiser ACE Study, the question pertained only to the mother being treated violently.3 Neglect questions were added to BRFSS ACEs module in 2019.Participant DemographicsDemographic Information for Participants Completing the 2011-2014 BRFSS ACE ModuleDemographic Information for U.S Participants Completing the 2011-2020 BRFSS ACE ModuleDemographic Information Percent (N = 264,882)GenderSexFemale 51.9%Male 48.0%Race/EthnicityWhite, non-Hispanic 63.1%Black, non-Hispanic 10.9%Another race, non-Hispanic 6.3%Multiracial, non-Hispanic 1.3%Hispanic 15.9%Age (years)18-24 11.9%25-34 16.0%35-44 16.0%45-54 16.1%55-64 17.0%65+ 22.0%Educational AttainmentLess than High School 12.3%High School Diploma/GED 27.7%Some College 31.1%College Degree 28.9%Note: Reports and articles that use data from other years and/or states may contain different estimates.Source: Swedo EA, Aslam MV, Dahlberg LL, et al. Prevalence of Adverse Childhood Experiences Among U.S. Adults — Behavioral Risk Factor Surveillance System, 2011–2020. MMWR Morb Mortal Wkly Rep 2023;72:707–715. DOI: http://dx.doi.org/10.15585/mmwr.mm7226a2.ACEs PrevalenceThe prevalence estimates reported below are for all 50 states and DC, 2011-2020 BRFSS ACEs module (n=264,882).Note: Reports and articles that use data from other years and/or other states may contain different estimates.Prevalence of ACEs by Category for Participants Completing the ACE Module on the 2011-2014 BRFSSPrevalence of ACEs by Category among U.S. Adults, 2011-2020 BRFSS ACEs ModuleACE Category Women Men TotalPercent Percent PercentABUSEEmotional Abuse 34.0% 34.0% 34.0%Physical Abuse 22.7% 24.0% 23.3%Sexual Abuse 17.7% 7.0% 12.6%HOUSEHOLD CHALLENGESIntimate Partner Violence 18.1% 16.3% 17.2%Substance Abuse 27.9% 25.0% 26.5%Mental Illness 19.9% 14.4% 17.3%Parental Separation or Divorce 28.4% 28.4% 28.4%Incarcerated Household Member 8.1% 9.3% 8.6%Note: Reports and articles that use data from other years and/or other states may contain different estimates.ACE Score Prevalence for Participants Completing the ACE Module on the 2010 BRFSSACE Score Prevalence among U.S. Adults, 2001-2020 BRFSS ACEs ModuleNumber of Adverse Childhood Experiences (ACE Score) Women Men TotalPercent Percent Percent0 36% 36.3% 36.1%1 22.1% 24.2% 23.1%2-3 22.7% 24.2% 23.5%4 or more 19.2% 15.2% 17.3%Note: Reports and articles that use data from other years and/or other states may contain different estimates.Source: Swedo EA, Aslam MV, Dahlberg LL, et al. Prevalence of Adverse Childhood Experiences Among U.S. Adults — Behavioral Risk Factor Surveillance System, 2011–2020. MMWR Morb Mortal Wkly Rep 2023;72:707–715. DOI: http://dx.doi.org/10.15585/mmwr.mm7226a2.Major FindingsThe prevalence of ACEs from the BRFSS data was similar to that of the original ACE Study. Almost two-thirds of surveyed adults reported at least one ACE and more than one in four reported three or more ACEs.ACEs are common across all populations. Some populations are more vulnerable to experiencing ACEs because of the social and economic conditions in which they live, learn, work and play.The ACE score is the total sum of the different categories of ACEs reported by participants. Study findings show a graded dose-response relationship between ACEs and negative health and well-being outcomes. In other words, as the number of ACEs increases so does the risk for negative health outcomes. For an exhaustive list of outcomes, see selected journal publications.Association between ACEs and Negative OutcomesTop of PageLast Reviewed: June 29, 2023Source:* Syndicateemail_03 Get Email UpdatesTo receive email updates about this page, enter your email address:Email AddressWhat's this?SubmitRelated Links* Data & Statistics (WISQARS)* Opioid Overdose Prevention* Traumatic Brain Injury* Motor Vehicle Safety* Press Room* About CDC* Contact Us* 800-232-4636Facebook Twitter Instagram LinkedIn Youtube Pinterest SnapchatFacebook Twitter Instagram LinkedIn Youtube Pinterest Snapchat RSS* CONTACT CDCContact UsCall 800-232-4636Email Us* ABOUT CDC+ About CDC+ Jobs+ Funding* POLICIES+ Accessibility+ External Links+ Privacy+ Policies+ Web Policies+ No Fear Act+ FOIA+ OIG+ No Fear Act+ Nondiscrimination+ Vulnerability Disclosure Policy+ CDC Archive+ Public Health Publications+ HHS.gov+ USA.gov* CONNECT WITH US+ Youtube+ Snapchat* LANGUAGES+ Español+ 繁體中文+ Tiếng Việt+ 한국어+ Tagalog+ Русский+ العربية+ Kreyòl Ayisyen+ Français+ Polski+ Português+ Italiano+ Deutsch+ 日本語+ فارسی+ English* U.S. Department of Health & Human Services* Accessibility* External Links* Privacy* Policies* Web Policies* FOIA* OIG* No Fear Act* FOIA* Nondiscrimination* OIG* Vulnerability Disclosure Policy* CDC Archive* Public Health Publications* HHS.gov* USA.govContent Credential×This image was edited or created using GenAI (generative artificial intelligence).Our experts review all images in an effort to ensure accuracy and quality before use.Learn more about CDC's usage of GenAI.
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