About ACEs

Adverse Childhood Experiences (ACEs) specifically refer to 10 types of abuse, neglect, and household dysfunction that, when encountered in early life, can negatively impact lifelong physical and mental health due to activation of the toxic stress response. ACEs are divided into three categories:

Abuse: Physical, Emotional, and Sexual

Neglect: Physical and Emotional

Household Challenges: Mental Illness, Mother Treated Violently, Drug or Alcohol Abuse, Incarceration, and Divorce

The burden of ACEs is not equally distributed, with a greater risk of exposure and negative outcomes among individuals in low socioeconomic and minoritized communities.

Exposure to ACEs puts individuals at risk for developing vulnerabilities to many physical and mental disorders, and greater exposure is directly linked to greater health risk. Known as ACE-Associated Health Conditions (AAHCs), these conditions include cardiovascular disease, chronic obstructive pulmonary disease (COPD), liver disease, cancer, diabetes, obesity, cognitive impairments, risky sexual behaviors, early and high-risk substance use, depression, suicidality, poor self-rated health, and early death.

Research Portfolio

Precision medicine holds promise to more fully apply data to improve health and advance equity. Over $20 million dollars of state funds have been awarded to support proof-of-principle demonstration projects for families and communities with Adverse Childhood Experiences (ACEs) with an aim to improve access, care, and outcomes through collaboration between academic, community, nonprofit, and industry partners. All projects were selected through a competitive RFP, and the 2021–22 State Budget provided an additional $12.4 million, to fully support a total of seven research teams. Each project will receive $2.5-3 million over three years, beginning summer 2021.

CIAPM 2023 ACEs Research Symposium

On November 1, CIAPM hosted a virtual research symposium showcasing seven State-funded projects on Adverse Childhood Experiences (ACEs). Drs. McCall and Reiner from CIAPM provided an overview of the research portfolio and Surgeon General Dr. Ramos delivered opening remarks. ACEs research teams from Children’s Hospital Los Angeles, Stanford University, Loma Linda University, UC Irvine, UC Los Angeles, UC San Francisco, and UC San Diego delivered brief presentations on their projects. Project team members engaged in rich discussions, sharing lessons learned and discussing paths forward.

Watch video on YouTube

Selection Process

Demonstration Projects were selected through a three-step competitive peer-review process by an independent, out-of-state Expert Selection Committee. Following the submission of Letters of Intent, expert reviewers employed a process for selection of Concept Proposals and Full Proposals (Finalist Stage) based on National Institutes of Health standards. Proposals were reviewed across several factors embedded in CIAPM's enabling statute, including the 1. potential for tangible benefit to patients within five years; 2. expertise of the team; 3. clinical and commercial potential; 4. potential to reduce health disparities; and 5. potential to scale and leverage multiple electronic health records systems, among other criteria listed in the RFP. Each proposal was also assigned an overall impact score. As per statutory requirements and the Request for Proposals, at least one project must be located in both northern and southern regions of California. Additionally, lead institutions may only receive one award.


  • A Tale of Two Treatments: Approaches to Preventing Long-Term Negative Health Sequelae Among Low-Income Latinx Youth with ACEs, UC Irvine
  • ACEs Mechanisms in Disease–The Role of DNA Methylation, UCLA
  • Getting to Healthy Outcomes of Pregnancy for Everyone: Addressing Risk for and Resiliency Against Adverse Pregnancy Outcomes in Women with Multiple Adverse Childhood Experiences and Their Infants (The HOPE-ACEs Study), UCSF
  • Integration of Biomarkers to Inform Tailored Disease Management and Behavioral Interventions for Homeless Youth Experiencing Toxic Stress, UCLA
  • Shared DataEcosytem: A New Paradigm to Build Community Resilience and Inform Resource Allocation, Stanford University
  • Effectiveness, Kaiser Permanente Southern California
  • A Precision Population Health Approach to Measuring and Reducing Exposure to ACEs in Inland Southern California, UC Riverside
  • ACEs and Specific Learning Disabilities: Patterns of Neurocognitive, Social, and Educational Features, UCSF
  • ACEs in Youth with Serious Mental Illness: The Need for Precision Medicine, UC Davis
  • And Still I RISE: Resilience In Students Experiencing ACEs, UC Davis
  • Biopsychosocial Predictors of Resilience and Treatment Effects in Youth Exposed to Adverse Childhood Experiences, UC Irvine
  • Collaborative Community ACES Intervention to Reduce Health Disparities and Close the Academic Acheivement Gap, Touro University California
  • Developing Biomarker-Informed Primary Care Screening Tools for Mental and Physical Health Risk in Adversity-Exposed youth, UCLA
  • Engineering an Integrated Systems Approach to Reduce ACEs and Promote Resilience in a Diverse Child, Adolescent, and Early Adult Population, Claremont Graduate University
  • Examining the Influence of Adverse Childhood Experiences and Childhood Stress on Brain Health Biomarkers in a Diverse Cohort of Older Adults Living in San Francisco, UCSF
  • Implementation and Evaluation of an ACE Screening and Treatment System, UC Merced
  • Interrupting Intergenerational Trauma: Trauma-Informed Approach to Public Health Nursing, UCSF
  • Mitigating Toxic Stress by Building Resilience in California's Latino Immigrant Communities: A Community-Engaged, Precision Medicine Approach, UC Davis
  • Nutritional Supplementation as a Means to Reduce Early Life Adversity In the Context of Substance Use in Pregnancy, UCSF
  • Precision Mental Health for Youth with Adverse Childhood Experiences From Low-Socioeconomic Status Families, UCSF
  • Ravenswood Wellness Partnership: Increasing Capacity and Access to Culturally Relevant and Responsive Mental Health and Wellness Services for Youth in East Palo Alto and Belle Haven, Stanford University
  • The Santa Barbara ACEs Project for Inclusion, Education and Diversity, Santa Barbara Cottage Hospital

For More Information

David Reiner, PhD
David Reiner is a Science Officer within the California Initiative to Advance Precision Medicine.