Document Type

Policy Brief

Publication Date



MRHRC, Behavioral Health, ACES, adverse childhood experiences, rural, research


Recent research shows that rural children are more likely than urban children to experience certain kinds of adversity. Researchers at the Maine Rural Health Research Center looked at how adverse childhood experiences (ACEs) have affected rural and urban adults. Using data from the Behavioral Risk Factor Surveillance System Assessment, this study found that, while the prevalence of ACEs was comparable in rural and urban adults, over half of rural adults surveyed reported having ACE exposure.Among those with any ACE history, about one quarter experienced four or more ACEs. Policy implications and strategies are highlighted in this brief.

Key Findings:

  • Past research has shown that adverse childhood experiences (ACEs) have long-term, negative implications for health and well-being: as the number of ACEs increases, the risk for health problems in adulthood rises.
  • Adverse childhood experiences (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.

Funding Organization or Grant

Federal Office of Rural Health Policy