Second, researchers should consider concepts of historical trauma and resilience in their efforts to understand ACEs among AI/AN populations. Child Trends’ brief notes that there is “no single agreed-upon list of experiences that encompass what we refer to as adverse childhood experiences.” To address links between ACEs and AI/AN well-being, it is essential that we understand whether some adversities are uniquely important to AI/AN contexts. For instance, AI/AN scholars have written for decades about the concept of multi-level, intergenerational impacts of historical trauma. Some have even begun to incorporate measures that capture symptoms of historical trauma alongside standard ACEs measures to better understand health outcomes for AI/AN youth.
Perhaps more importantly, tribal contexts also include unique strengths. Many tribes have invested in programs and services that enhance and revitalize the languages, traditions, and values that have sustained AI/AN peoples and communities for centuries. Understanding how these cultural elements have fostered—and continue to foster—resilience in the face of adversity will be critical for developing relevant and effective ACEs prevention and intervention for AI/AN populations.
Finally, tribal sovereignty must be acknowledged to address resource needs and develop sustainable ACEs prevention and intervention strategies. Tribal programs and services tasked with delivery of support in tribal contexts are often severely underfunded. To overcome this challenge, partners interested in addressing ACEs among AI/ANs must acknowledge that, in addition to comprising a racial/ethnic category, tribes have access to powerful policy and program levers to address population health and well-being. This means that federal policies with tribal implications require government-to-government consultation. Furthermore, national and state-level collaboration with tribes on policy and program initiatives, funding mechanisms, and services to address ACEs can ensure that tribes take part in and benefit from future solutions.
The study of ACEs is rapidly evolving. Applying an equity lens to this field will ensure that AI/ANs are included in attempts to understand and address ACEs and their impacts, thereby promoting more equitable outcomes for all children. This will require deliberate efforts to include AI/ANs in new studies and to address measurement and resource needs that exist in AI/AN contexts. However, even the sparse existing data indicate that ACEs are common among AI/ANs, and that increased attention to adverse experiences among AI/AN children stands to tremendously benefit their long-term well-being.
 Census data in this blog are from Table S0201: Selected Population Profile in the United States, 2016 American Community Survey 1-year estimates. State-level 2016 ACS 1-year estimates were not available for North Dakota and Wyoming, which were within the top 10 states with the highest percentage of AI/ANs according to the 2010 U.S. Census; therefore, for comparisons across states, estimates for ND and WY were taken from TableS0201: Selected Population Profile in the United States, 2013 American Community Survey 3-year estimates.