Experts tell committee North Dakotans report high rates of adverse childhood experiences; prevention, trauma‑informed care urged

Dr. Ramona Danielson, assistant professor in the Department of Public Health at North Dakota State University, told the Protection and Victim Services Committee that adverse childhood experiences—abuse, neglect and household dysfunction before age 18—remain common in North Dakota and are linked to a wide range of long‑term health and social harms.

"In the time period that we looked at, 2019 to 2022," Danielson said, "36 percent of North Dakota adults indicated that they experienced emotional abuse, 22 percent physical abuse, and 11 percent sexual abuse," and she reported that 17 percent of adults had ACE scores of four or more. Using PRAMS (pregnancy surveillance) data, she said 21 percent of recent mothers had four or more ACEs.

Danielson framed ACEs as a population‑level risk factor with a dose‑response relationship: people with higher ACE scores face higher risks of chronic disease, mental‑health disorders, substance use disorders and premature mortality. "People with an ACE score of 4 or more," she said, "die on average 20 years younger than people with 0 ACEs," noting the finding as a population statistic rather than a deterministic prediction for individuals.

Committee members asked how the state compares nationally and whether apparent increases reflect more willingness to report. Danielson said North Dakota is generally on par with national averages but emphasized limitations of retrospective self‑report (BRFSS) and the influence of changes in screening and disclosure on apparent trends. "It is possible that people who are younger are more willing to think about things that happen to them as being an adverse childhood experience," she said.

On interventions, Danielson pointed to evidence‑based programs such as maternal‑infant and early‑childhood home visiting, efforts to strengthen families financially, and initiatives that connect children with caring adults. She urged expanding trauma‑informed, healing‑centered approaches and adding measures of protective factors to state surveillance so policymakers can track both risks and supports.

Members raised equity concerns after Danielson noted higher ACE prevalence in some groups, including American Indian and Alaska Native populations, and higher concentrations of ACEs among people with lower educational attainment or income. Danielson also highlighted children with special needs as a particularly vulnerable population, saying they are "three times more likely to be abused or neglected."

The committee did not take formal action on the presentation; members scheduled further committee discussion at 02:20 to follow up on prevention and programmatic questions.

The committee originally convened, completed a voice vote to approve minutes of its Sept. 30 meeting, and recessed for lunch before the second presentation.