Adverse Childhood Experiences:

A Mid-Atlantic Investigation

Dele Durojaye

April 30, 2018


Adverse childhood experiences (ACEs) are described as traumatic events ranging
from household dysfunction to abuse and neglect that lead to negative effects
on one’s physical or behavioral health [1]. The list of nine ACEs that are more
recently focused on include socioeconomic hardships, single parent households,
violence in one’s surrounding and discrimination [4]. Growing up with ACEs has
proposed effects on a child’s health and ultimately lifespan. For instance,
previous research suggested a relationship between reports of ACEs and substance
abuse in one’s later life [2, 3]. In this investigation specifically, a child’s
conduct and behavior is used as the health condition in relation to the nine ACEs,
which will ultimately lead to discoveries on their relationship.


Does the increased presence of ACEs in a household have an effect on a child’s
behavioral health?


This analysis extends throughout the states categorized as Mid-Atlantic States:
Delaware, Maryland, New Jersey, New York, Virginia, and West Virginia. Due to
privacy laws, NSCH is unable to report specific zip codes, so the grains will
remain at the state level.


For analysis, the data was filtered to only contain answers for questions relating
to any of the nine adverse childhood experiences and cases of diagnoses behavioral
and conduct problems. In each survey question pertaining to an ACE, families
were asked to report information based on a single child chosen at random, in
the event that there were multiple children in the home. On the scale, values
of “1” symbolized the child experienced that particular ACE in their household.
Likewise, survey response values of “3” meant the child currently has the
behavioral condition.

Data Source

The data used below was obtained from the Data Resource Center in the National
Survey of Children Health [4]


Of the Mid-Atlantic States, Pennsylvania has the highest number of households
with at least one child with a diagnosed behavioral problem, followed by Maryland,
Delaware, and West Virginia, respectively.

The following three data tables are plotted on their respective bar graphs below.
Of the states, Pennsylvania ranks with the highest reported cases of drug/alcohol
abuse, a jailed parent, low income, mental health, and parental divorce. Meanwhile,
Delaware ranks as the state with the highest number of individual households
with reported parental deaths, neighborhood violence, and discrimination experiences.
Other states like West Virginia and New Jersey, also had high rankings in ACEs.

Concerning the relative proportions of ACEs per household, Pennsylvania has the
highest mean number of 0.957, followed by West Virginia with 0.886. As also seen
in the plot, Pennsylvania has the highest proportion of 8 ACEs per household
which largely affects the mean. Inversely, New York has the lowest mean of ACEs
per household and also carries the lowest number of households with diagnosed
behavioral problems. The data supports the conclusion that the increased presence
of ACEs in a household have an effect on a child’s behavioral health.

Main Conclusions

After looking at the nine adverse childhood experiences presented above, both
Pennsylvania and West Virginia rank as the states with the highest number of
households with ACEs. Those experiences specifically include drug/alcohol abuse,
domestic violence, low income, mental health, and divorced parents. Even though
outlier states, such as Delaware, had unexpected high ranks in the other ACE’s,
the data supports the thesis that experiencing an ACE in one’s household leads
to an increased risk for developing a behavioral health problem.
When it comes to raising a family, it is important to be cautious of how environmental
influences affect a child’s health. If possible to remove a child from a
potentially harmful experience, they could benefit long term. The data presented
above can be used by families across America to assess the health risks their
children face. Then in the future, to address this issue, community initiatives
to reduce each of these effects could be made. For instance, a particular
community could work towards decreasing neighborhood violence at the least, while
other communities could work towards reducing discrimination. Generally speaking,
taking initiative on a personal scale and within the household is the first step
to raising healthy children.


[1] Adverse Childhood Experiences. (2017, May 09). Retrieved from
[2] Rothman, E. F., Edwards, E. M., Heeren, T., & Hingson, R. W. (2008). Adverse
Childhood Experiences Predict Earlier Age of Drinking Onset: Results From a
Representative US Sample of Current or Former Drinkers. American Academy of
Pediatrics, 122 (2), 298 - 304.
[3] Leung, J. PK., Britton, A., & Bell, S. (2015). Adverse Childhood Experiences
and Alcohol Consumption in Midlife and Early Old-Age. Alcohol and Alcoholism,
51 (3), 331 - 338.
[4] Data Resource Center/ U.S. Department of Health and Human Services, Health
Resources and Services Administration (2012). “2011/12 National Survey of Children’s
Health” [.csv file] Retrieved from