Maternal and Child Health Journal

, Volume 20, Issue 4, pp 843–853 | Cite as

The Comorbidity of Physical, Mental, and Developmental Conditions Associated with Childhood Adversity: A Population Based Study

  • Melissa A. Bright
  • Caprice Knapp
  • Melanie S. Hinojosa
  • Shannon Alford
  • Brandy Bonner
Original Paper


Objective Adverse childhood experiences (ACEs) are associated with myriad health conditions and risk behaviors in both adolescents and adults. In this study we examine the association between ACEs and specific physical, mental, and developmental conditions, as well as their comorbidity, in a nationally representative sample of children 0–17 years. Methods Data from the 2011–2012 National Survey for Child Health (NSCH) were used. A total of 95,677 random-digit-dial interviews with parents of children 0–17 years were conducted across all 50 states and the District of Columbia. Outcomes included singular condition domains (physical, mental, and developmental) as well as combinations of condition domains (e.g., physical plus mental, mental plus developmental, etc.). Results Twenty-three percent of parents reported that their child experienced 1 ACE; 9.2 % experienced 2 ACEs, and 10.3 % experienced three or more. Across all three condition domains and combinations of domains, children who experienced at least one ACE were more likely than children who experienced 0 ACEs to have at least one condition. Additionally, greater ACEs was associated with increased likelihood of at least one condition in each domain and in multiple domains. Conclusions for practice These findings support the extension of existing family environment screening tools in pediatric practices as well as the establishment of a system for monitoring ACEs in families with multiple or complex conditions.


Adverse childhood experiences Pediatrics Comorbidity Public health 



Administration for children and families


National Center for Chronic Disease Prevention and Health Promotion


American Academy of Pediatrics


Adverse childhood experiences


Federal poverty level


National Study of Children’s Health


Child and adolescent measurement initiative



The corresponding author (MB) had full access to all of the data under a data use agreement between CAHMI’s Data Resource Center and Melanie Sberna Hinojosa. The authors take responsibility for the integrity of the data and the accuracy of the data analysis. None of the authors have potential conflicts of interest to declare. The manuscript uses publicly available data and subsequently did not require ethical approval from the Institutional Review Board.

Compliance with Ethical Standards

Conflict of interest

The authors have no conflicts of interest to declare.


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Melissa A. Bright
    • 1
  • Caprice Knapp
    • 2
  • Melanie S. Hinojosa
    • 3
  • Shannon Alford
    • 1
  • Brandy Bonner
    • 1
  1. 1.Institute for Child Health PolicyUniversity of FloridaGainesvilleUSA
  2. 2.Department of Health Policy and AdministrationThe Pennsylvania State UniversityState CollegeUSA
  3. 3.Department of SociologyUniversity of Central FloridaOrlandoUSA

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