Wisconsin Adverse Childhood Experiences ACE Data Findings from

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Wisconsin Adverse Childhood Experiences (ACE) Data Findings from 2011 -2015 Wisconsin Behavioral Risk Factor

Wisconsin Adverse Childhood Experiences (ACE) Data Findings from 2011 -2015 Wisconsin Behavioral Risk Factor Surveillance System (BRFSS)

Content ACEs overview Slides 3 Overall ACE prevalence in Wisconsin 4 -6 ACE prevalence

Content ACEs overview Slides 3 Overall ACE prevalence in Wisconsin 4 -6 ACE prevalence by household income 7 -12 ACE prevalence by race/ethnicity 13 -15 ACEs and health outcomes 16 -19 ACEs and smoking 20 -26

ACE overview • Adverse childhood experiences (ACEs) are negative life events or experiences which

ACE overview • Adverse childhood experiences (ACEs) are negative life events or experiences which occur during childhood and have the potential to impede healthy child development. • Wisconsin includes the ACE module in the state's annual Behavioral Risk Factor Surveillance System (BRFSS). To assess the occurrence of ACEs among Wisconsin adults, the BRFSS asks if they experienced any of the following events or circumstances prior to the age of 18: • Recurrent physical abuse • Recurrent emotional abuse • Sexual abuse • An alcohol or other drug abuser in the household • An incarcerated family member • A household member who was chronically depressed, mentally ill, institutionalized or suicidal • Violence between adults in the home • Parental separation or divorce • Poverty/neglect (questions added to ACE module in 2014)

Prevalence of Individual ACEs in Wisconsin 57% 43% 57% of Wisconsin Residents have at

Prevalence of Individual ACEs in Wisconsin 57% 43% 57% of Wisconsin Residents have at least 1 ACE Findings from the 2011 -2015 Behavioral Risk Factor Survey

Household Dysfunction 26% of Wisconsin residents grew up with someone who struggled with substance

Household Dysfunction 26% of Wisconsin residents grew up with someone who struggled with substance abuse Substance abuse 26% Parent separate/divorce 23% Violence between adults 16% Mental illness 16% Incarceration 7% Findings from the 2011 -2015 Behavioral Risk Factor Survey

Abuse 28% of Wisconsin residents grew up experiencing emotional abuse Emotional 28% Physical Sexual

Abuse 28% of Wisconsin residents grew up experiencing emotional abuse Emotional 28% Physical Sexual 16% 9% Findings from the 2011 -2015 Behavioral Risk Factor Survey

ACE Distribution by Current Household Income 0 ACEs 1 ACEs 2 -3 ACEs 4+ACEs

ACE Distribution by Current Household Income 0 ACEs 1 ACEs 2 -3 ACEs 4+ACEs <$20, 000 31% 22% 24% 22% $20, 000 -$34, 999 40% 22% 21% 17% $35, 000 -$49, 999 45% 21% 14% $50, 000 46% 23% 21% 10% Findings from the 2011 -2015 Behavioral Risk Factor Survey

ACEs are more prevalent among those with lower income 0 ACEs 69% Any ACE

ACEs are more prevalent among those with lower income 0 ACEs 69% Any ACE 60% 55% 45% 54% 46% 40% 31% <$20, 000$34, 999 $35, 000$49, 999 Findings from the 2011 -2015 Behavioral Risk Factor Survey >$50, 000

ACEs are more prevalent among those with lower income <$20, 000$34, 999 $35, 000$49,

ACEs are more prevalent among those with lower income <$20, 000$34, 999 $35, 000$49, 999 >$50, 000 0 ACEs 31% Any ACE 69% 40% 60% 45% 55% 46% Findings from the 2011 -2015 Behavioral Risk Factor Survey 54%

ACEs are more prevalent among those with lower income 0 ACEs <$20, 000$34, 999

ACEs are more prevalent among those with lower income 0 ACEs <$20, 000$34, 999 31% 40% Any ACE 69% 60% $35, 000$49, 999 45% 55% >$50, 000 46% 54% Findings from the 2011 -2015 Behavioral Risk Factor Survey

Households with lower incomes are more likely to have 4 or more ACEs 22%

Households with lower incomes are more likely to have 4 or more ACEs 22% 17% 14% 10% <$20, 000 -$34, 999 $35, 000 -$49, 999 Findings from the 2011 -2015 Behavioral Risk Factor Survey $50, 000

Nearly 1 out of 4 individuals with <$20, 000 household income have 4 or

Nearly 1 out of 4 individuals with <$20, 000 household income have 4 or more ACEs 22% 17% 14% 10% <$20, 000 -$34, 999 $35, 000 -$49, 999 Findings from the 2011 -2015 Behavioral Risk Factor Survey $50, 000

ACE Distribution by Race/Ethnicity 0 ACEs 1 ACEs 2 -3 ACEs 4+ACEs Black 20%

ACE Distribution by Race/Ethnicity 0 ACEs 1 ACEs 2 -3 ACEs 4+ACEs Black 20% 26% 28% 26% Native American 23% 19% 27% 31% Hispanic/Latin@ 33% 27% 16% White 45% 22% 20% 13% Asian* 58% 23% 15% 4% *Statistically insignificant due to low sample size Findings from the 2011 -2015 Behavioral Risk Factor Survey

Blacks and Native Americans have higher rates of ACEs than Whites, Hispanic/Latinos, and Asians

Blacks and Native Americans have higher rates of ACEs than Whites, Hispanic/Latinos, and Asians 0 ACEs Any ACE Black 20% 80% Native American 23% 77% Hispanic/Latin@ White Asian* 33% 45% 58% 67% 55% 42% *Statistically insignificant due to low sample size Findings from the 2011 -2015 Behavioral Risk Factor Survey

Blacks and Native Americans have higher rates of ACEs than Whites Hispanic/Latinos, and Asians

Blacks and Native Americans have higher rates of ACEs than Whites Hispanic/Latinos, and Asians Black Any ACE 20% 80% 0 ACEs Native American 23% Hispanic/Latin@ White Asian* 77% 33% 67% 45% 58% 42% *Statistically insignificant due to low sample size Findings from the 2011 -2015 Behavioral Risk Factor Survey

ACEs and Health Outcomes 0 ACEs 1 ACEs 2 -3 ACEs 4+ACEs Asthma 9%

ACEs and Health Outcomes 0 ACEs 1 ACEs 2 -3 ACEs 4+ACEs Asthma 9% 12% 15% 22% Poor/Fair general health 11% 13% 18% 23% Ever diagnosed with depression 8% 15% 22% 36% Frequent mental distress (14+ bad mental health days in past 30 days) 4% 9% 12% 24% Findings from the 2011 -2015 Behavioral Risk Factor Survey

Both asthma and fair to poor general health are correlated with more ACEs 23%

Both asthma and fair to poor general health are correlated with more ACEs 23% 22% 18% 15% 11% 13% 12% 9% 0 1 2 to 3 Findings from the 2011 -2015 Behavioral Risk Factor Survey 4+

Both asthma and fair to poor general health are correlated with more ACEs 4+

Both asthma and fair to poor general health are correlated with more ACEs 4+ 23% Fair/Poor General Health Current Asthma 22% 18% 2 to 3 15% 13% 1 0 12% 11% 9% Findings from the 2011 -2015 Behavioral Risk Factor Survey

Both depression and frequent mental distress are correlated with more ACEs 36% 24% 22%

Both depression and frequent mental distress are correlated with more ACEs 36% 24% 22% 15% 9% 8% 12% 4% 0 1 2 to 3 4+ Ever Diagnosed with Depression Frequent Mental Distress (14+ Bad MH Days in last 30) Findings from the 2011 -2015 Behavioral Risk Factor Survey

Individual ACEs and Smoking Rates Household Dysfunction Smoking Rate Incarcerated 44% Drug abuse 36%

Individual ACEs and Smoking Rates Household Dysfunction Smoking Rate Incarcerated 44% Drug abuse 36% Divorce 31% Violence between adults 30% Problem drinker 29% Depression/suicidal/mentally ill 28% Findings from the 2011 -2015 Behavioral Risk Factor Survey

Individual ACEs and Smoking Rates Abuse Smoking Rate Sexual abuse – forced to have

Individual ACEs and Smoking Rates Abuse Smoking Rate Sexual abuse – forced to have sex 40% Sexual abuse – victim forced to touch perpetrator 36% Sexual abuse – victim touched 31% Physical abuse 30% Emotional abuse 26% Findings from the 2011 -2015 Behavioral Risk Factor Survey

Smoking rates increase as ACE scores increase 35% 23% 18% 11% 0 1 2

Smoking rates increase as ACE scores increase 35% 23% 18% 11% 0 1 2 to 3 Findings from the 2011 -2015 Behavioral Risk Factor Survey 4+

Individuals with 4 or more ACEs smoke at rates double that of the Wisconsin

Individuals with 4 or more ACEs smoke at rates double that of the Wisconsin average (19%) 35% 23% 18% 11% 0 1 2 to 3 Findings from the 2011 -2015 Behavioral Risk Factor Survey 4+

All household dysfunction ACEs have higher rates of smoking than the overall Wisconsin average

All household dysfunction ACEs have higher rates of smoking than the overall Wisconsin average 19% 44% Incarcerated 36% Drug Abuse Divorce Violence between adults Problem Drinker Depressed/suicidal/mentally ill Findings from the 2011 -2015 Behavioral Risk Factor Survey 31% 30% 29% 28%

All abuse ACEs have higher rates of smoking than the overall Wisconsin average 19%

All abuse ACEs have higher rates of smoking than the overall Wisconsin average 19% Sexual Abuse- forced to have sex Sexual abuse – Forced to have sex 40% Sexual abuse – Victim forced to touch Sexual Abuse - victim forced to touch perpetrator 36% Sexual abuse – Victim touched Sexual Abuse - victim touched Physical Abuse Physical abuse Emotional Abuse Emotional abuse Findings from the 2011 -2015 Behavioral Risk Factor Survey 31% 30% 26%

All poverty ACEs have higher rates of smoking than the overall Wisconsin average 17%

All poverty ACEs have higher rates of smoking than the overall Wisconsin average 17% Homeless when growing up Hungry because family couldn’t afford food Findings from the 2011 -2015 Behavioral Risk Factor Survey *Wisconsin started collecting this data in 2014 45% 30%

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