Introduction: Adverse Childhood Experiences (ACE) are common among the population. Based on the reported data and studies, the prevalence of ACEs related health issues is significantly high throughout the U.S. While policies and programs exist to address ACEs, more information is needed to understand the number of states that have legislation and the specific initiatives that fall under the legislation.

Method: To preliminarily answer this question, several online search engines were utilized: Google, PubMed, ACEs Connection Website, ACE Too High, CDC Website, state health department website, and ASTHO. From these sources, documented state legislations on ACEs were identified using the search terms policies, programs, state legislation, ACEs, toxic stress, childhood trauma, and childhood adversity. Information was organized within Excel Spreadsheets by sector, initiative, for each state.

Result: Based on the CDC website, only 12 states and the District of Columbia utilized the Optional ACE module from 2009 to 2012. Throughout the US, only half of the states have ACE-related legislations within four main sectors identified as education, healthcare, child welfare and juvenile justice. The information on Puerto Rico and U.S. territories for ACEs legislation was not evident. Among the 24 states that have legislation to address ACEs, California and Vermont have 7 specific initiatives, Washington state has 6, Massachusetts has 5, and Oregon and Tennessee have 4. House and Senate Bills were identified for four states including Massachusetts, Tennessee, Virginia, and Washington state. Most legislation are associated with child welfare and education sectors. Juvenile justice sector had the greatest gaps.

Conclusion: From the present assessment it appears that there is a lack of data on the prevalence of ACEs among adults across states. Furthermore, most of the initiatives around ACEs are focused on child welfare and education sectors. However, to have a strong impact on ACEs prevention, legislation should exist that cover multiple sectors. The role of monitoring the population through data collection is needed to inform policies set for the prevention and treatment of ACEs.