The current adverse childhood experience (ACE) survey does not include exposure to community violence (ECV) as a category. A new study by Lee, Larkin, and Esaki (2017) point to evidence that ECV fits the World Health Organization (WHO)’s classification for an ACE category, that it must: cause biological stress response, be sensitive to policies, be common across societies, be able to be measured quickly and easily, and be proximal in respect to causality (WHO, 2011).
Lee et al. (2017) analyzed data collected as part of the 2009 New York State (NYS) Omnibus survey to assess ECV’s occurrence and its implications. The 10 standard ACE items were asked in the survey as well as an additional ECV question: “Did you ever see someone in your neighborhood threaten or seriously hurt another person?” Use of behavioral health services and sociodemographic variables were also obtained.
The results indicate that ACE scores and ECV are significantly associated; 24% of the participants with 1 or 2 ACEs reported ECV and 51% of the participants with 3 or more ACEs witnessed community violence. Behavioral health service use was also significantly more likely among respondents with a high exposure to community violence than those who rarely or ever witnessed it. In addition, those who reported any ECV were 2.7 times more likely to use behavioral health services than those who did not. The only sociodemographic variable found to be significant was that African Americans were half as likely to use services compared to Whites.
These results point to adverse long-term effects of ECV and to its utility as an additional ACE category. Given the high service costs of ACEs, including ECV, this research can help to inform policymakers and service providers. Early intervention, particularly in school settings, for youth with exposure to community violence would help to prevent its adverse effect in adulthood.