Legislating to Prevent Adverse Childhood Experiences: Growth and Opportunities for Evidence-Based Policymaking and Prevention

Since the landmark study of Adverse Childhood Experiences (ACEs; Felitti et al., American Journal of Preventive Medicine, 14(4):245–258, 1998 ), there has been a significant growth in efforts to address ACEs and their impact on individual health and well-being. Despite this growing awareness, there...

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Published in:	Prevention science 2022-02, Vol.23 (2), p.181-191
Main Authors:	Crowley, D. Max, Connell, Christian M., Noll, Jennie, Green, Lawrie, Scott, Taylor, Giray, Cagla
Format:	Article
Language:	eng
Subjects:	Adults Behavior Child abuse & neglect Child and School Psychology Childhood Childhood experiences Demography Disease prevention Domestic Violence Enactment Evidence-based practice Health care Health Psychology Health risk assessment Health risks Households Humans Legislation Legislators Medicine Medicine & Public Health Mental health Mortality Policy Making Political identity Political parties Political power Politics Prevention Public Health Public policy Systematic review United States Voter behavior Voting
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Summary:	Since the landmark study of Adverse Childhood Experiences (ACEs; Felitti et al., American Journal of Preventive Medicine, 14(4):245–258, 1998 ), there has been a significant growth in efforts to address ACEs and their impact on individual health and well-being. Despite this growing awareness, there has been little systematic review of state legislative action regarding variation in focus or scope or of the broader context impacting the introduction and enactment of ACE-related policy efforts. To inform the role of psychologists and related professionals to contribute to these legislative efforts, we conduct a comprehensive mixed-method analysis of all state bills introduced over the past two decades to investigate the use and impact of ACE research in introduced and enacted state legislative language (51 states, N Total Bills = 1,212,048, N ACE Bills = 425). In addition, these analyses examine congressional office communications ( N = 14,916,546 public statements) and voting records ( N = 1,163,463 votes) to understand the relationship between legislative members’ public discussion of ACEs and their voting behavior on these bills. We find that legislators’ public discourse is significantly related to ACE-related policymaking above and beyond political affiliation or demographic characteristics. Furthermore, key legislative language related to domestic violence, evidence-based practice, and prevention were significant predictors of whether an ACE-related bill becomes law—above and beyond the political party in power. These analyses highlight the ways in which ACE-related research has informed state policy. Based upon this work, we offer recommendations for researchers and policymakers.
ISSN:	1389-4986 1573-6695