Adverse childhood experiences (ACEs) are disturbances in
family relationships that deprive children of the
security and emotional support they need for healthy
development. Although a recent report by the Health
Resources and Service Administration indicated that rural
children have higher rates of ACEs than their urban
peers, we know of no studies examining rural-urban
differences in adults' exposure to ACEs. This study was
designed to address this research gap and to inform
health system initiatives geared toward mitigating the
impacts of ACEs on rural populations.
- Past research has shown that ACEs have long-term,
negative implications for health and well-being: as the
number of ACEs increases, the risk for health problems in
- ACEs are a significant problem among rural adults.
Over half of rural residents reported some ACE exposure,
and over one in ten reported high levels of exposure
(four or more ACEs).
- After adjustment for demographics, rural and urban
populations showed similar odds of experiencing
high-level ACE exposure.
- Rural primary care providers can play a leadership
role in forging community partnerships to raise public
awareness about ACEs, conduct ACE-focused community needs
assessments, and launch initiatives to create new
services geared toward building resilience in families.