Seven percent of the nearly 1.7 million Medi-Cal members aged 0-20 who were screened for adverse childhood experiences (ACEs) between Jan. 1, 2020, and March 31, 2024, had an ACE score of four or more, according to a recent report.
According to the ACEs and Toxic Stress Risk Assessment Algorithm, people who score zero are at low risk for toxic stress, those who score one to three with no associated health conditions are at intermediate risk, and individuals who score one to three with associated health conditions or four or more are at high risk.
This latest data was reported by ACEs Aware, a first-in-the nation statewide initiative to screen patients for ACEs and treat toxic stress in hopes of improving Californians’ health and well-being.
Toxic stress is “the body’s response to lasting and serious stress, without enough support from a caregiver. When a child doesn’t get the help [they] need, [their] body can’t turn off the stress response normally. This lasting stress can harm a child’s body and brain and can cause lifelong health problems. This type of stress results from exposure to things like abuse and neglect.”
According to ACEs Aware, “children are uniquely vulnerable to the effects of an overactive stress response because their brains and bodies are still developing. While the plasticity in the brain during early childhood and adolescence is a source of vulnerability to ACEs, there is also an opportunity for effective intervention and treatment … Routine and universal ACEs screening helps clinical teams provide more effective and equitable health care. Screening results can be used to provide targeted clinical interventions, as well as offer greater compassion, patience, and the opportunity for relational healing.”
Alameda, Inyo, Marin, Monterey, Orange, Riverside, San Bernardino, Santa Barbara and Tehama counties screened the largest percent of Medi-Cal members in this age range at between 29 and 45 percent.
The counties with the highest percentage of individuals aged 0-20 who had four or more ACEs included Amador, Butte, Calaveras, Colusa, Del Norte, Glenn, Lake, Lassen, Mariposa, Modoc, Nevada, Plumas, Shasta, Siskiyou, Sutter, Tuolumne and Yuba (although many were among the counties with the smallest percentage of young people screened, at under 4 percent). Sierra County appeared to have the smallest percentage of young people with four or more ACEs though only 3 percent of the population was screened.
“ACEs Aware offers clinical teams training, clinical protocols, and payment for screening children, adolescents, and adults for ACEs,” according to the report. “Since the launch of the ACEs Aware initiative in December 2019, more than 43,870 individuals have completed the ACEs Aware core training, including approximately 20,720 Medi-Cal clinicians in California who are ACEs Aware-certified and eligible to receive Medi-Cal payment for conducting ACE screenings.”
More than 489,000 adults aged 21-64 were screened during the period from January 2020 to March 24, of whom 17 percent had an ACEs score of at least four.
Learn more about ACEs Aware and find related resources here.
