Maternal and Child Health Journal

, Volume 19, Issue 11, pp 2492–2500 | Cite as

Adverse Childhood Experiences, the Medical Home, and Child Well-Being

  • Kelly Stamper Balistreri



To examine the relationship between adverse childhood experiences (ACE), access to a medical home and a global measure of well-being among children ages 6–17 using the 2011–2012 National Survey of Children’s Health.


Multivariate linear regressions assessed the associations between each adverse experience and an index of child well-being with and without the impact of other events. The number of ACE was summed for each respondent and the analyses were repeated with the cumulative score as a continuous variable. The cumulative model was repeated with the addition of an interaction term between ACE score and medical home access. All analyses were conducted separately for children ages 6–11 and adolescents 12–17.


Over half (53 %) of US children ages 6–17 have experienced some adverse experience during childhood. Over a quarter (28 %) has experienced at least two adverse experiences, while 15 % have experienced three or more hardships. Results suggest that the accumulation of ACE reduces well-being in children. The associations remained significant after controlling for gender, race/ethnicity, age, parental education, special health condition, and medical home access. Medical home access was consistently associated with higher levels of child well-being and was a significant moderator of the relationship between the total ACE and child well-being among children ages 6–11. Children with ACE exposure and access to a medical home have higher levels of well-being than comparable children without access to a medical home.

Conclusions for Practice

Children exposed to adverse experiences have measurably lower levels of well-being, although younger children with access to a medical home are protected at increasing exposure.


Adverse childhood experiences (ACE) Child well-being Medical home 



Infrastructure support was provided by the Center for Family and Demographic Research which has core funding form The Eunice Kennedy Shriver National Institute of Child Health and Human Development (R24HD050959).


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Center for Family and Demographic ResearchBowling Green State UniversityBowling GreenUSA

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