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Overview
Welcome to the Adverse Childhood Experiences (ACEs) and Positive Childhood Experiences (PCEs) Surveillance Hub! Whether you want to learn more about ACEs and PCEs surveillance, assess and understand different data sources, or turn data into action, you’re in the right place.
First, let’s ground ourselves in the broad definition of public health surveillance.
PUBLIC HEALTH SURVEILLANCE is the ongoing and systematic collection, analysis, and interpretation of health-related data. These data are essential to planning, implementing, and evaluating of public health efforts.
The purpose of public health surveillance is to provide ongoing information that can be used to inform data-driven action.
We can use public health surveillance to:
- Describe the burden and changes over time.
- Identify populations at disproportionate risk and then use the information to tailor prevention and intervention strategies.
- Monitor and evaluate the effectiveness of prevention and intervention strategies.
- Monitor efforts to reduce the disproportionate burden of poor health and achieve health equity.
This hub focuses on a specific type of public health surveillance—adverse childhood experiences and positive childhood experiences.
- Adverse childhood experiences (ACEs) are potentially traumatic events in childhood (0-17 years), like neglect and experiencing or witnessing violence in the home or community. Also included are aspects of a child’s environment that can undermine their sense of safety, stability, and bonding, such as living in a household where a parent or caregiver is negatively affected by substance use or an ongoing mental health condition. While these are some examples, it’s important to remember this is not an exhaustive list.
- Positive childhood experiences (PCEs) are experiences in childhood related to a child’s ability to have safe, stable, and nurturing relationships and environments. They include things like having nurturing, supportive relationships with parents, other adults, and peers. Also included are living, developing, playing, and learning in safe, stable, nurturing environments, and having opportunities to try new things and connect with others.
It’s important to pay attention to both ACEs and PCEs because they both affect health outcomes and public health in general.
It might help to think of it this way:
Imagine a child is a seedling trying to grow into a strong, healthy, fruit-bearing tree.
The fruit represents the different potential health outcomes the child may experience throughout their life, but it’s not the only thing worth paying attention to.
If a child is a seedling, then ACEs are the weeds—they can interfere with the seed’s ability to grow, develop, and thrive.
PCEs, meanwhile, are nourishing water and sunlight—they encourage and are critical to the seed’s growth, even if weeds are also present.
Understanding ACEs and PCEs Data
What Are Self-Reported ACEs Data?
Self-reported ACEs data refers to the direct data collection of information on ACEs from the individual who experienced the ACE. This includes types of ACEs that have historically been included in ACEs measures, such as child abuse or neglect, and types of ACEs that have been included and prioritized in ACEs measures more recently, such as interpersonal discrimination or housing instability.
Historically, ACEs data have generally come from adults who reported retrospectively on ACEs that they experienced during their childhood. An example of this are data collected on ACEs from the Behavioral Risk Factor Surveillance System (BRFSS). More recently, ACEs data have also been collected from children. An example of this are data collected on ACEs from the Youth Risk Behavior Surveillance System (YRBSS). Data collected from adults can help communicate the burden of ACEs generally, and data collected from children can reflect the burden of ACEs among children currently.
Collecting self-reported ACEs data in a state, territory, tribal nation, or community can help you communicate the burden of ACEs to partners, policymakers, and the public so we can work together to prioritize prevention, intervention, and response efforts that help children and families.
What Are ACEs Indicators?
ACEs indicators are data elements that are related to ACEs (or are proxies, or “stand-ins,” for ACEs), but they are not the exact measurements of ACEs. Data on ACEs indicators are useful for guiding further investigation, and they are often the best available information because self-reported ACEs data can be difficult to obtain. It is important to understand that ACEs indicators do not fully capture information about ACEs and may under or overcount the existence of ACEs. This is because indicators may only capture some aspects of an ACE or they may capture data from an observer (such as a parent or caregiver), who may not know about all of the child’s experiences.
What Are the Potential Outcomes of ACEs?
Outcomes of ACEs include the social, behavioral, educational or economic opportunity or health consequences linked to experiencing ACEs. These outcomes must occur after the ACE but could occur later in childhood or adulthood. It’s important to note that possible outcomes of ACEs are not ACEs – they are the short- and long-term consequences of experiencing ACEs.
Measuring potential outcomes of ACEs can demonstrate the importance of ACEs prevention because they show the vast number of diseases and economic opportunity costs that have been associated with increased risk after experiencing ACEs. Measuring potential outcomes of ACEs can also demonstrate the long-term impact of prevention activities.
Throughout this hub, you’ll find Learning Modules where you are able to explore topics in detail. Progress will not be saved.
Learn MoreIn this module, you’ll explore two critical puzzle pieces of ACEs surveillance—data and indicators.
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