New reports on Adverse Childhood Experiences in North Carolina and the South

From the Frank Porter Graham Child Development Institute

Adverse childhood experiences, or ACEs, are potentially traumatic events that occur in childhood (0-17 years). Examples include covering basic living expenses with family income; witnessing violence in the home or community; and having a family member attempt or die by suicide. In addition, growing up in a home in which individuals are dealing with substance use, mental health problems, instability due to parental separation or household members being in jail or prison can undermine a child’s sense of well-being, stability, and bonding.

To share the most recent data on the accumulation and types of ACEs in North Carolina and the South, Daniel Gitterman, PhD, a Faculty Fellow at the UNC Frank Porter Graham Child Development Institute (FPG) and Duncan MacRae ’09 and Rebecca Kyle MacRae Professor of Public Policy, led the development of two recently published policy briefs, Adverse Childhood Experiences (ACEs) in North Carolina, 2016-22 and Adverse Childhood Experiences (ACEs) in the South and U.S., 2022. The reports, produced in collaboration with research assistant Ivey Parks, MPP, and Durham-based nonprofit MDC—where Gitterman is a senior fellow—quantify the problem and help bring renewed attention to social policies that address child poverty and well-being.

ACEs often have lasting, negative effects on health and well-being, as well as life opportunities such as education and employment. Research has found that the risk for more adverse outcomes increases with the exposure to a number of ACEs. Federal, state, and local policy makers and community leaders need to understand the prevalence of these experiences so that they can work to prevent and respond to these challenges. Preventing ACEs and reducing the damage that they cause, through public policy and community-based efforts, helps build healthy families.

The team used the most recent data—responses from 2016 to 2022—released from the National Survey of Children’s Health (NSCH), which is supported by the U.S. Department of Health and Human Services’ Health Resources and Services Administration (HRSA) Maternal and Child Health Bureau (MCHB).

The survey questions included:

• Since this child was born, how often has it been very hard to cover the basics, like food or housing, on your family’s income?
• Parent/guardian divorced or separated?
• Parent/guardian died?
• Parent/guardian served time in jail?
• Saw or heard parents or adults slap, hit, kick, or punch one another in the home?
• Was a victim of violence or witnessed violence in his or her neighborhood?
• Lived with anyone who was mentally ill, suicidal, or severely depressed?
• Lived with anyone who had a problem with alcohol or drugs?
• Was treated or judged unfairly because of his or her race or ethnic group?
• Was treated unfairly because of a health condition or disability?
• Was treated unfairly because of their sexual orientation or gender identity?

The last two questions were added to the survey in 2021 and 2020, respectively.

For the report on the South, the team used the U.S. Census Bureau’s definition of the region, with the exception of Maryland, Delaware, Oklahoma, and the District of Columbia. The states reported on are Florida, Georgia, North Carolina, South Carolina, Virginia, West Virginia, Alabama, Kentucky, Mississippi, Tennessee, Arkansas, Louisiana, and Texas, which align with MDC’s focus area.

Gitterman said that poverty is a predictor of many ACEs and can be considered an ACE itself. “My approach to this work was from a policy perspective, although I appreciate the on-the-ground work that’s going on around trauma and other issues,” he said. “In my mind, the real trauma is economic trauma, which shows itself in a whole series of related ACEs.” In 2023, more than three-quarters of the Southern region states had child poverty rates of 17.0% or more. In North Carolina, 17.3% of children were living below the federal poverty threshold in 2022.

Other findings include significant racial disparities, with Black and Hispanic children more likely than white children to experience ACEs, both in North Carolina and throughout the South. North Carolina was significantly worse on ACEs and racial disparities compared with the South. The four most common ACEs experienced by children were divorce, income insecurity, alcohol/drug abuse, and mental illness.

Gitterman said that this work shows the type of trauma and adversity that too many children and adolescents are facing. While Parks assumed that the income insecurity ACE would have increased, especially during COVID, the findings showed that it decreased over time. “Some of the COVID economic relief packages might have caused a decrease in income insecurity, which was interesting to see,” she said.

The project’s goal was to create highly accessible briefs aimed at a general audience. That audience includes those working in the field of child well-being. Gitterman released a copy of the report directly to the North Carolina Department of Health and Human Services, the Kate B. Reynolds Charitable Trust, and Blue Cross Blue Shield of North Carolina. Gitterman hopes to see partners work together to address the underlying issues, utilizing this state-level data.

Strengthening families’ economic security can help reduce parental stress, establish greater household stability, and protect children. Policy and systemic reforms can make a difference since children thrive when their families are economically secure. The brief notes that “wrapping benefits and resources around families triples to quadruples the odds that they achieve major economic outcomes—including increased levels of education, employment, income, and financial stability.”

MDC Director of Communications Clarissa Goodlett, said that her organization works with a network of individuals and communities who are actively engaged on the ground around issues of educational equity and economic mobility. “We are grateful for data analysis that connects to the impacts and experiences we witness in this environment,” she said. “These reports provide those we’re working with resources and tools to advocate for the investments and policy changes that need to happen. Some of our funders and colleagues work on programmatic action and advocacy, so being able to share data that is accessible and easy to understand is helpful.”

Read the entire article here.