New Study Shows High Prevalence of Harmful Adverse Experiences among Children: Most Comprehensive Look at National and State-Level Data

July 30, 2014

Bethesda, Md. — Children who are subjected to major, potentially traumatic events have an increased risk of poor health and illness as adults. A new report from Child Trends shows that just under half of children in the U.S. have had at least one of these adverse experiences, and that having had a large number of them can affect well-being as early as adolescence. Additionally, the prevalence of adverse childhood experiences varies dramatically across the states.

Child Trends analyzed data from the 2011-12 National Survey of Children’s Health, consisting of interviews of more than 95,000 adults about a child in their household, to find out about the prevalence of adverse childhood experiences nationwide and for each state in the U.S. Most prior studies of adverse childhood experiences have been restricted to specific segments of the population.

Researchers looked at eight of the nine adverse childhood experiences included in the national survey, including economic hardship; parent or guardian was separated or divorced; lived with someone with alcohol or drug problems; lived with someone who was mentally ill or suicidal; was a victim of or witness to neighborhood violence; witnessed domestic violence in their home; lived with a parent or guardian who had spent time incarcerated; and lived with a parent or guardian who died.

The resulting report highlights state-level variance in the tribulations faced by children. The most common adverse childhood experience in most states was economic hardship, meaning it was often difficult for families to cover food or housing costs on their income level. Over one-quarter of children have experienced this, according to the study.

“The data show that these experiences are not rare, but their prevalence varies dramatically state-to-state,” said Vanessa Sacks, a research analyst at Child Trends and an author of the study. “For example, more than one in ten kids nationally has lived with someone who has an alcohol or drug use problem. In Montana, almost one in five children has, while in Georgia, it’s less than one in 10.”

How adverse experiences affect teens:

Researchers also examined the association between teenagers’ well-being and their history of adverse experiences. “Nationally, 15 percent of teens ages 12 to 17 have had three or more of the adverse experiences we looked at,” Sacks said. “These youth are not doing as well as their peers.”

Nearly half of teenagers who have had three or more adverse experiences have low levels of engagement in school, and more than 20 percent have repeated a grade. These youth are far more likely to argue a lot or even to bully or be cruel to others.

Key National and State-Level Findings

The study’s key national findings include:

  • One in ten kids has experienced three or more of the eight included adverse experiences.
  • Divorce or separation of parents or guardians is the second-most-common adverse experience nationally, after economic hardship.

The prevalence of adverse experiences varies by state. Some stand-outs include:

  • In Connecticut, Maryland, and New Jersey, 60 percent or more of children have never had any of the adverse experiences measured in the survey.
  • Oklahoma has rates in the highest quartile for all of the adverse experiences.
  • In the District of Columbia, having been victim or witness to neighborhood violence has the second-highest prevalence, after economic hardship.
  • Among adolescents ages 12 to 17:

15 percent in Mississippi have witnessed domestic violence in their home;

19 percent in Maine have lived with someone who was mentally ill;

26 percent in Arizona have lived with someone with alcohol or drug problems; and

15 percent in Kentucky have lived with a parent or guardian who served time in jail or prison.

Action Steps

The report, which was funded by the Annie E. Casey Foundation, calls for increased attention to the conditions in families and communities that contribute to the occurrence of adverse childhood experiences. It also suggests having more training of pediatricians, child welfare and juvenile justice caseworkers, family court judges, school personnel (including for early childhood), and others who work closely with children, for the early detection and treatment of children affected by trauma.

“Policymakers should review the prevalence of these experiences for their state,” Sacks said. “Once they know where the problems are most pronounced, they can begin to prioritize and address them.”


Child Trends is a nonprofit, nonpartisan research center that studies children at all stages of development. Its mission is to improve the lives and prospects of children and youth by conducting high-quality research and sharing the resulting knowledge with practitioners and policymakers. Child Trends has more than 100 employees and annual revenue of about $13