Development of an adverse childhood experience (ACE) index to help explain adult physical health, mental health, and receiving needed emotional support.

OBJECTIVE: To develop an adverse childhood experience (ACE) index using 2023 Behavior Risk Factor Surveillance System data and assess its association with adult health and seeking emotional support. METHOD: ). Regression estimates were adjusted for age, sex, race/ethnicity, marital status, education, and income. Average ACE index scores significantly decreased with older age, higher education, and higher income. They were significantly lower in men and Hispanics (vs. other race/ethnic groups) but significantly higher in the previously married (vs. other marital status groups). As the average ACE index score increased, the frequency of seeking needed emotional support, of feeling stress, of poor mental health days, and of poor physical health days during adulthood significantly increased in a linear fashion. The ACE index more strongly predicted these outcomes than the demographic variables. It positively correlated with adult stress, poor physical and mental health, and insufficient emotional support in adulthood. CONCLUSION: The ACE index is a valid composite measure of ACE items and predicted later life events. (PsycInfo Database Record (c) 2026 APA, all rights reserved).