ArticlePloS one2020
Disease burden of adverse childhood experiences across 14 states.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06063174 (Identifying Social, Molecular, & Immunological Processes for Mitigating Toxic Stress & Enhancing Personalized Resilience), which is not on this map. Cited by 41 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Identifying Social, Molecular, & Immunological Processes for Mitigating Toxic Stress & Enhancing Personalized Resilience
Who cites it
41 citing papers in PubMed, 2 syntheses or guidelines pooled it, 90 citations in OpenAlex.
- Association between adverse childhood experiences and asthma: a meta-analysis.BMC public health · 2026Pooled it
- Adverse childhood experience is associated with an increased risk of reporting chronic pain in adulthood: a stystematic review and meta-analysis.European journal of psychotraumatology · 2023Pooled it
- Early Exposure to a Parent's Alcohol Use Disorder as an Adverse Childhood Experience: Neurobiological and Clinical Consequences in Adulthood.Medical science monitor : international medical journal of experimental and clinical research · 2026Review
- Association between Adverse Childhood Experiences and Binge Drinking among Adults: The Moderating Effect of Race/Ethnicity.Journal of racial and ethnic health disparities · 2026Article
- The Revised ACE Pyramid: A Contemporary Framework for Understanding Childhood Adversity and Advancing Toxic Stress Prevention and Healing.Children (Basel, Switzerland) · 2026Article
- Giving children a stronger start: Qualitative insights from first Five California's campaign to address adverse childhood experiences and toxic stress.PEC innovation · 2026Article
- Early-life determinants of cardiometabolic outcomes and accelerated biological ageing in Colombia.Aging · 2026Article
- Associations between adverse childhood experiences and cardiometabolic health in later adulthood in Colombia.Journal of epidemiology and community health · 2026Article
- Adverse Childhood Experiences and Life Course Adversity Related to Geriatric Syndromes: A Narrative Review.Medicina (Kaunas, Lithuania) · 2026Review
- Adverse Childhood Experiences and Mortality at Old Age: A Longitudinal Study from the Japan Gerontological Evaluation Study.Journal of child & adolescent trauma · 2026Article
- Adverse childhood experiences are associated with falling among middle-aged and older adults, US 2023 BRFSS data.The journals of gerontology. Series A, Biological sciences and medical sciences · 2026Article
- Childhood maltreatment and adult diseases in the general population: the mediating role of smoking and overweight in a time-sequence design.BMC public health · 2025Article
- The association between adverse childhood experiences and chronic respiratory diseases in the Chinese middle-aged and elderly population.BMC public health · 2025Article
- Exploring the link between adverse childhood experiences and cancer development - insights and intervention recommendations from a scoping review.Npj mental health research · 2025Article
- Exposure to childhood maltreatment is associated with specific epigenetic patterns in sperm.Molecular psychiatry · 2025Article
- SCD and asthma comorbidity: the potential role of adverse childhood experiences.Journal of sickle cell disease · 2025Article
- Article
- Associations between childhood trauma, depression, anxiety disorders and early arthritis presence.Frontiers in medicine · 2025Article
- Clinician actions in response to Adverse Childhood Experience (ACE) screening.Preventive medicine reports · 2024Article
- Role of Adverse Childhood Experiences in the Onset of Overweight/Obesity.Current obesity reports · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo examine whether the relationship between Adverse Childhood Experiences (ACEs) and health outcomes is similar across states and persists net of ACEs associations with smoking, heavy drinking, and obesity.
methodsWe use data from the Behavioral Risk Factor Surveillance System for 14 states. Logistic regressions yield estimates of the direct associations of ACEs exposure with health outcomes net of health risk factors, and indirect ACEs-health associations via health risk factors. Models were estimated for California (N = 22,475) and pooled data from 13 states (N = 110,076), and also separately by state.
resultsExposure to ACEs is associated with significantly higher odds of smoking, heavy drinking, and obesity. Net of these health risk factors, there was a significant and graded relationship in California and the pooled 13-state data between greater ACEs exposure and odds of depression, asthma, COPD, arthritis, and cardiovascular disease. Four or more ACEs were less consistently associated across states with cancer and diabetes and a dose-response relationship was also not present. There was a wide range across individual states in the percentage change in health outcomes predicted for exposure to 4+ ACEs. ACEs-related smoking, heavy drinking, and obesity explain a large and significant proportion of 4+ ACEs associations with COPD and cardiovascular disease, however some effect, absent of risk behavior, remained.
conclusionsACE's associations with most of the health conditions persist independent of behavioral pathways but only asthma, arthritis, COPD, cardiovascular disease, and depression consistently exhibit a dose-response relationship. Our results suggest that attention to child maltreatment and household dysfunction, mental health treatment, substance abuse prevention and promotion of physical activity and healthy weight outcomes might mitigate some adverse health consequences of ACEs. Differences across states in the pattern of ACEs-health associations may also indicate fruitful areas for prevention.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.