{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T18:08:46Z","timestamp":1784830126165,"version":"3.55.0"},"reference-count":14,"publisher":"BMJ","funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Inj Prev"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adverse childhood experiences (ACEs) are preventable, potentially traumatic events occurring before age 18, and are linked to numerous negative outcomes throughout life. Recent national studies report that ACEs are common among US high school students, but the prevalence of ACEs by state and local jurisdiction is unknown. The study objective was to estimate the prevalence of individual and cumulative ACEs among high school students in 16 US jurisdictions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using 2023 Youth Risk Behavior Survey data, we estimated the self-reported prevalence of eight individual (emotional, physical or sexual abuse; physical neglect; witnessed intimate partner violence; parental substance use problems; parental mental health problems; incarcerated or detained parent\/guardian) and cumulative ACEs (0, 1, 2\u20123, \u22654) among high school students &lt;18 years in 16\u2009US jurisdictions that included ACEs questions on their survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Emotional abuse was the most reported ACE (range: 49.3%\u201364.0%)\u2009in all jurisdictions. In 13 of 16 jurisdictions, the other most common ACEs included physical abuse (20.8%\u201346.9%), parental mental health problems (23.6%\u201338.6%) and parental substance use problems (17.6%\u201333.1%). Jurisdiction-specific variation in the relative commonality and prevalence of individual and cumulative ACEs was present.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and conclusions<\/jats:title>\n                    <jats:p>While some estimates overlapped, individual ACEs prevalence varied widely by site, highlighting the need for local data to inform prevention strategies. Local estimates can help decision makers understand communities\u2019 unique risks and strengths and evaluate progress towards preventing and mitigating ACEs using strategies from Centers for Disease Control and Prevention\u2019s Preventing Adverse Childhood Experiences Resource for Action.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/ip-2025-046123","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T17:20:27Z","timestamp":1784827227000},"page":"ip-2025-046123","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence of adverse childhood experiences among high school students: a cross-sectional analysis of 16 jurisdictions in the USA"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8835-5022","authenticated-orcid":false,"given":"Elizabeth A","family":"Swedo","sequence":"first","affiliation":[{"name":"Division of Violence Prevention, National Center for Injury Prevention and Control, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asma","family":"Akram","sequence":"additional","affiliation":[{"name":"Division of Violence Prevention, National Center for Injury Prevention and Control, Atlanta, Georgia, USA"},{"name":"Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Schwank","sequence":"additional","affiliation":[{"name":"Division of Violence Prevention, National Center for Injury Prevention and Control, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7220-5350","authenticated-orcid":false,"given":"C Nicole","family":"White","sequence":"additional","affiliation":[{"name":"Division of Violence Prevention, National Center for Injury Prevention and Control, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tia","family":"Rogers","sequence":"additional","affiliation":[{"name":"Division of Violence Prevention, National Center for Injury Prevention and Control, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayla N","family":"Anderson","sequence":"additional","affiliation":[{"name":"Office of Strategy and Innovation, National Center for Injury Prevention and Control, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norah W","family":"Friar","sequence":"additional","affiliation":[{"name":"Division of Violence Prevention, National Center for Injury Prevention and Control, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaveen","family":"Henderson","sequence":"additional","affiliation":[{"name":"Division of Violence Prevention, National Center for Injury Prevention and Control, Atlanta, Georgia, USA"},{"name":"Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phyllis","family":"Niolon","sequence":"additional","affiliation":[{"name":"Division of Violence Prevention, National Center for Injury Prevention and Control, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,23]]},"reference":[{"key":"2026072310201862000_ip-2025-046123v1.1","unstructured":"Centers for Disease Control and Prevention . Adverse childhood experiences (ACEs) prevention resource for action: a compilation of the best available evidence. Atlanta, GA National Center for Injury Prevention and Control; 2019. Available: https:\/\/www.cdc.gov\/violenceprevention\/pdf\/ACEs-Prevention-Resource_508.pdf"},{"key":"2026072310201862000_ip-2025-046123v1.2","doi-asserted-by":"crossref","first-page":"S31","DOI":"10.1016\/j.amepre.2021.11.017","article-title":"Building Infrastructure for Surveillance of Adverse and Positive Childhood Experiences: Integrated, Multimethod Approaches to Generate Data for Prevention Action","volume":"62","author":"Anderson","year":"2022","journal-title":"Am J Prev Med"},{"key":"2026072310201862000_ip-2025-046123v1.3","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2023.46323","article-title":"Economic Burden of Health Conditions Associated With Adverse Childhood Experiences Among US Adults","volume":"6","author":"Peterson","year":"2023","journal-title":"JAMA Netw Open"},{"key":"2026072310201862000_ip-2025-046123v1.4","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7226a2"},{"key":"2026072310201862000_ip-2025-046123v1.5","doi-asserted-by":"crossref","first-page":"39","DOI":"10.15585\/mmwr.su7304a5","article-title":"Adverse Childhood Experiences and Health Conditions and Risk Behaviors Among High School Students - Youth Risk Behavior Survey, United States, 2023","volume":"73","author":"Swedo","year":"2024","journal-title":"MMWR Suppl"},{"key":"2026072310201862000_ip-2025-046123v1.6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.su7304a1","article-title":"Overview and Methods for the Youth Risk Behavior Surveillance System - United States, 2023","volume":"73","author":"Brener","year":"2024","journal-title":"MMWR Suppl"},{"key":"2026072310201862000_ip-2025-046123v1.7","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-3797(98)00017-8"},{"key":"2026072310201862000_ip-2025-046123v1.8","unstructured":"Centers for Disease Control and Prevention . Guidance for analyzing 2021 ACEs & PCEs data: youth risk behavior survey. Atlanta, GA US Department of Health and Human Services; 2023. Available: https:\/\/www.cdc.gov\/violenceprevention\/pdf\/YRBS-ACEs-PCEs-Analytic-Recommendations-CLEARED_508.pdf"},{"key":"2026072310201862000_ip-2025-046123v1.9","first-page":"11993","article-title":"Proposed data collection submitted for public comment and recommendations","volume":"85","year":"2020","journal-title":"Fed Regist"},{"key":"2026072310201862000_ip-2025-046123v1.10","doi-asserted-by":"crossref","unstructured":"Massey M , Virkar S . Results of cognitive testing of questions on adverse childhood experiences for the youth risk behavior surveillance system. Q-Bank - question evaluation reports. National Center for Health Statistics; 2022. Available: https:\/\/stacks.cdc.gov\/view\/cdc\/150784","DOI":"10.15620\/cdc\/150784"},{"key":"2026072310201862000_ip-2025-046123v1.11","unstructured":"Wilkins N , Tsao B , Hertz M , et al . Connecting the Dots: An Overview of the Links among Multiple Forms of Violence. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 2014."},{"key":"2026072310201862000_ip-2025-046123v1.12","doi-asserted-by":"crossref","first-page":"382","DOI":"10.14301\/llcs.v8i4.414","article-title":"Adverse childhood experiences, non-response and loss to follow-up: Findings from a prospective birth cohort and recommendations for addressing missing data","volume":"8","author":"Doidge","year":"2017","journal-title":"Longitud Life Course Stud"},{"key":"2026072310201862000_ip-2025-046123v1.13","doi-asserted-by":"crossref","first-page":"107339","DOI":"10.1016\/j.chiabu.2025.107339","article-title":"Parent-teen concordance of selected adverse childhood experiences in a national sample of teenagers: Findings from National Health Interview Survey - Teen","volume":"163","author":"Ng","year":"2025","journal-title":"Child Abuse Negl"},{"key":"2026072310201862000_ip-2025-046123v1.14","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291799002111"}],"container-title":["Injury Prevention"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/ip-2025-046123","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T17:20:29Z","timestamp":1784827229000},"score":1,"resource":{"primary":{"URL":"https:\/\/injuryprevention.bmj.com\/lookup\/doi\/10.1136\/ip-2025-046123"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,23]]},"references-count":14,"alternative-id":["10.1136\/ip-2025-046123"],"URL":"https:\/\/doi.org\/10.1136\/ip-2025-046123","relation":{},"ISSN":["1353-8047","1475-5785"],"issn-type":[{"value":"1353-8047","type":"print"},{"value":"1475-5785","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,23]]}}}