Idaho BRFSS Adverse Childhood Experiences

Adverse childhood experiences, or ACEs, are preventable, potentially traumatic events that occur in childhood (0-17 years) such as abuse, neglect, and other household challenges. Also include are aspects of a child's environment that can undermine their sense of safety, stability, and bonding, such as growing up in a household with substance use' mental health problems; or instability due to parental separation of incarceration of a parent, sibling, or other member of the household.

The Idaho Behavioral Risk Factor Surveillance System (BRFSS) included multiple questions related to ACEs in 2018 and 2020 surveys which have been categorized into two areas; household challenges and abuse. Adults BRFSS respondents were asked if they experienced various ACEs as a child. The analysis of those responses included statewide estimates of the occurrence of specific ACEs as well as the relationship between ACEs and other health-related conditions and risk behaviors.Additional information about analysis resulting in statistically significant differences and relationships can be found in the companion reports located in the Notes section. To access these reports and other information about the Idaho BRFSS data, definitions, and methods is available by clicking the "Notes, Data & Other Info" button on the dashboard.

The Behavioral Risk Factor Surveillance System (BRFSS) is a public health surveillance program developed and partially funded by the federal Centers for Disease Control and Prevention (CDC). The BRFSS is designed to provide state and sub-state estimates for the prevalence of chronic disease, injury, health conditions, and health-related behaviors associated with the major causes of death and disability. Idaho has worked with CDC to conduct the BRFSS each year since its inception in 1984. The BRFSS has grown to include every state, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, the Federated States of Micronesia, and Palau. The 2018 and 2020 Idaho BRFSS data were collected using voluntary and anonymous public health surveys conducted by the Idaho Division of Public Health in coordination with CDC. Trained survey interviewers used randomly selected landline and cellular telephone numbers to contact Idaho adults aged 18 or older. Phone numbers were selected using disproportionately stratified sampling, with the state's seven public health districts defined as strata. One adult was randomly selected for interviewing from all adults living in each landline household contacted. Cellular telephone users were considered primary users of their phone number and were interviewed directly.  Interviewers used computer-assisted telephone interviewing (CATI) software to record participant responses, and respondents were interviewed in English or Spanish according to the participant’s preference. Additional information about BRFSS methodology is available from CDC (https://www.cdc.gov/brfss). The BRFSS survey included questions standardized by CDC and asked in all states (core), questions standardized by CDC and asked optionally by Idaho (modules), and state-added questions specific to Idaho. Each standardized question was developed and tested by CDC. Data Aggregation and Weighting: Responses from both survey years were combined for analysis. Because any sample of people rarely reflects the true proportions of subgroups within a population, certain subgroups may be under or over-represented. To account for known differences between the sample and the population, sample data were weighted using census data to accurately reflect subgroup proportions in the adult population. Further information about data weighting is available from the American Association of Public Opinion Research (http://www.aapor.org/Education-Resources/For-Researchers/Poll-Survey-FAQ/Weighting.aspx). Data Processing, Analysis, and Reporting:Idaho used SAS® v9.4 software for data manipulation and risk factor creation. Idaho used SAS-callable SUDAAN® (Survey Data Analysis) v11.0.3 software for calculation of confidence intervals and statistical testing. SUDAAN enabled analysts to account for the complex sampling design of the BRFSS survey. Responses of "Don't know," "Not sure," and "Refused" were excluded from analyses. Prevalence estimates are reported as percentages (%). Estimates with fewer than 50 responses were considered statistically unreliable and are suppressed. Adverse Childhood Experience (ACE) Definitions:Household Challenges ACEsLived with a Drug User: Did you live with anyone who used illegal street drugs or who abused prescription medications?Lived with a Heavy Alcohol Drinker: Did you live with anyone who was a problem drinker or alcoholic?Lived with Someone Mentally Ill: Did you live with anyone who was depressed, mentally ill, or suicidal?Lived with Someone who was Incarcerated: Did you live with anyone who served time or was sentenced to serve time in a prison, jail, or other correctional facility?Parents' Marital Status: Were your parents separated or divorced? Abuse ACEs: (Verbal/Physical Abuse)Parents or Adults Verbally Abused Child: How often did a parent or adult in your home ever swear at you, insult you, or put you down?Parents or Adults Physically Abused Child: Before age 18, how often did a parent or adult in your home ever hit, beat, kick, or physically hurt you in any way? Do not include spanking.Parents or Adults Physically Abused Each Other: How often did your parents or adults in your home ever slap, hit, kick, punch, or beat each other up? (Sexual Abuse)Parents or Adults Forced Child to have Sex: How often did anyone at least 5 years older than you or an adult force you to have sex?Parents or Adults Forced Child to Touch Them Sexually: How often did anyone at least 5 years older than you or an adult try to make you touch them sexually?Parents or Adults Touched Child Sexually: How often did anyone at least 5 years older than you or an adult, ever touch you sexually?Health Outcome/Risk Factor Definitions: 14 or more Days of Poor Mental Health: 14 or more days during the past 30 days that mental health (including stress, depression, and problems with emotions) was not good.14 or more Days of Poor Physical Health: 14 or more days during the past 30 days that physical health (including physical illness and injury) was not good.Arthritis: Ever diagnosed with arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia.Asthma: Diagnosed with, and currently has, asthma.Binge Drinking: Drank 5 or more (men) or 4 or more (women) alcoholic beverages (12-ounce beer, 5-ounce wine, one shot of liquor) on a single occasion in the past 30 days.Cigarette Smoker: Smokes cigarettes every day or some days.Coronary Heart Disease or Angina: Ever diagnosed with angina or coronary heart disease.Current E-Cigarette User: Uses e-cigarettes or other electronic vaping products every day or some days.Current Nicotine User: Smokes cigarettes, uses e-cigarettes, or smokeless tobacco products every day or some days.Diabetes: Ever diagnosed with diabetes.Did not Always Wear a Seatbelt: Sometimes, seldom, or never wears a seatbelt while driving or riding in a car.Did not have a Flu Vaccine in the Past 12 Months: Did not have a flu vaccine sprayed in nose or injected into arm in the past 12 months. Did not have a Routine Checkup in the Last Year: Did not visit a doctor for a routine checkup in the past 12 months.Did not have Dental Visit in Past 12 Months: Did not visit a dentist (including hygienists, orthodontists, oral surgeons, and all other dental specialists) or dental clinic for any reason in past 12 months.Did not have PAP Test in the Past 3 Years: Did not have a PAP test in past 3 years (women ages 21-65).Did Not Meet Breast Cancer Screening Recommendations (50-74 [imputed]): Did not have a mammogram in the past 2 years (women ages 50-74).Did Not Seek Medical Care Due to Cost: Any time in the past 12 months when medical care from a doctor was needed but was not received due to cost.Drunk Driving in Past 30 Days: Drove after having too much to drink at least once during the past 30 days.Ever Diagnosed with Depression: Ever diagnosed with a depressive disorder (including depression, major depression, dysthymia, or minor depression).Fair or Poor Health: Self-assessed general health as fair or poor.Heart Attack: Ever diagnosed with a heart attack or myocardial infarction.Heavy Drinking: Drank more than 14 (men) or 7 (women) alcoholic beverages in a week in the past 30 days.Kidney Disease: Ever diagnosed with a kidney disease (not including kidney stones, bladder infection, or incontinence). Lower Respiratory Disease: Ever diagnosed with a chronic obstructive pulmonary disease (COPD), emphysema, or chronic bronchitis.Never Had a Pneumonia Vaccine (Age 65+): Ever had a pneumonia shot (pneumococcal vaccine; adults ages 65 and older).No Health Care Coverage: Does not have any kind of health care coverage including health insurance, prepaid plans, HMOs, Medicare, or Indian Health Service.No Leisure Time Physical Activity: Did not participate in any non-job-related physical activity or exercise in the past 30 days.No Personal Health Care Provider: Did not have a personal doctor or health care provider.Non-Skin Cancer: Ever diagnosed with any type of cancer other than skin cancer.Obese (BMI>30): Had a body mass index (BMI) greater than 30.Overweight & Obese (BMI>25): Had a BMI greater than 25.Skin Cancer: Ever diagnosed with skin cancer.Smokeless Tobacco Use: Uses smokeless tobacco (including chewing tobacco, snuff, or snus) every day or some days.Stroke: Ever diagnosed with a stroke.