Adverse Childhood Experiences across Birth Generation and LGBTQ+ Identity, Behavioral Risk Factor Surveillance System, 2019

Objectives. To identify and describe differences in exposure to adverse childhood events (ACEs) by birth generation and lesbian, gay, bisexual, transgender, and queer plus (LGBTQ1) identity. Methods. Using data from the 2019 Behavioral Risk Factor Surveillance System, we examined the odds of experiencing 4 or more ACEs for Generation X, millennials, and Generation Z relative to baby boomers (n 5 56 262). We also explored differences between generations based on LGBTQ1 identity. Results. The odds of experiencing 4 or more ACEs were higher for Generation X (odds ratio [OR] 5 1.67; 95% confidence interval [CI] 5 1.52, 1.83), millennials (OR 5 2.12; 95% CI 5 1.92, 2.35), and Generation Z (OR 5 2.12; 95% CI 5 1.79, 2.52) than for baby boomers. This disparity was amplified by LGBTQ1 identity (P 5 .016). The frequency of individual ACEs also varied by generation. Conclusions. Exposure to 4 or more ACEs has increased for each generation since the baby boomers, and more so for the LGBTQ1 population. The ACEs experienced differ by generation. Public Health Implications. Increasing ACE scores suggest that younger generations may have an increased risk of ACE-related health problems. Policies are needed to prevent ACE exposure and address the potential fallout from the ACEs that have seen the largest increases.