Adverse Childhood Experiences (ACE) among American Indians in South Dakota and Associations with Mental Health Conditions, Alcohol Use, and Smoking.

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Journal of health care for the poor and underserved


psjh_core; Adolescent; Adult; Aged; Alcohol Drinking; Female; Health Status Disparities; Health Surveys; Humans; Indians, North American; Life Change Events; Male; Mental Disorders; Middle Aged; Prevalence; Smoking; South Dakota; Young Adult


OBJECTIVES: To assess the prevalence of Adverse Childhood Experiences (ACEs) and their association with behavioral health in American Indian (AI) and non-AI populations in South Dakota.

METHODS: We included the validated ACE questionnaire in a statewide health survey of 16,001 households. We examined the prevalence of ACEs and behavioral health conditions in AI and non-AI populations and associations between ACEs and behavioral health.

RESULTS: Compared with non-AIs, AIs displayed higher prevalence of ACEs including abuse, neglect, and household dysfunction and had a higher total number of ACEs. For AIs and non-AIs, having six or more ACEs significantly increased the odds for depression, anxiety, PTSD, severe alcohol misuse, and smoking compared with individuals with no ACEs.

CONCLUSIONS: American Indians in South Dakota experience more ACEs, which may contribute to poor behavioral health. Preventing and mitigating the effects of ACEs may have a significant impact on health disparities in AI populations.

Clinical Institute

Mental Health


Behavioral Health