Explain the health impact of adverse childhood experiences (ACEs) in the United States

ACEs include childhood physical, emotional, or sexual abuse; witnessing domestic violence; and growing up with household substance abuse, mental illness, parental divorce, and/or an incarcerated household member. ACEs are associated with higher rates of heart disease, cancer, chronic bronchitis or emphysema, hepatitis or jaundice, skeletal fractures, and poor self-rated health. More recently, researchers have documented relationships between ACEs and autoimmune hospitalizations, headaches, alcoholism, homelessness, and self-reported quality of life. In 2009, a subset of 11 ACE-related questions was developed for addition to the Behavioral Risk Factor Surveillance System. Five states that adopted the subset found that 59.4% of respondents reported having at least one ACE, and 8.7% reported five or more ACEs. The highest prevalence rate was for substance abuse (25.9%), followed by verbal abuse (25.9%) and physical abuse (14.8%).When considering family dysfunction, 26.6% reported separated or divorced parents; 19.4% reported that they had lived with someone who was depressed, mentally ill, or suicidal; and 16.3% reported witnessing domestic violence.?