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Adverse childhood experiences (ACEs) are events of abuse, neglect, and household dysfunction that occur between birth and 17 years of age. Multiple studies have established the association between ACEs and risky behaviors and poor physical and mental health outcomes in childhood and beyond. Rural and minority children often have higher rates of ACE exposure than their peers. Yet previous results on ACEs and rurality have shown mixed results due to differences in: 1) geographic coverage of studied datasets, 2) measurement of ACEs, and 3) sampling methodologies. Furthermore, examinations of intra-rural differences in ACEs among racial/ethnic groups, particularly among American Indian/Alaska Native populations, have been limited. The findings from this study will inform and improve prevention and intervention efforts for rural children in the U.S.
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