Adverse childhood experiences and mental health in adulthood: Evidence from North Carolina

•ACE-affected people experience significantly more days of poor mental health in adulthood than the ACE-unaffected and there is a dose response.•They have a significantly higher likelihood of depression diagnosis in adulthood, and there is a dose response.•Living with a mentally ill person in childhood is the most consistent predictor of poor mental health in adulthood. About 1.4 million adults in North Carolina (NC) have mental illnesses. Many get no treatment because of mental health care provider shortages. Necessary prevention requires identification of covariates of mental illness. We tested the hypotheses: There is no difference in adulthood mental health of the ACE-affected and the unaffected; ACEs do not significantly predict adulthood mental health. ACEs studied were: living with a mentally ill person, an alcoholic, or drug abuser; witnessing violence; having divorced or unmarried parents; and being physically, mentally or sexually abused. We used data from 2012 and 2014 NC Behavioral Risk Factor Surveillance System. We had 19,187 observations with about 13,900 including ACE data. We conducted t- and χ2 tests of mental health differences between ACE-affected and unaffected and regression analysis to determine mental health predictors. ACE distribution was: 26.2% had parents or adults swearing at- or insulting them; 25% had divorced or unmarried parents; 22.6% lived with an alcoholic; 15.7% witnessed their parents beat each other; 13.8% lived with a mentally ill person; and 13.6% were hit or beaten by an adult in the home. Respondents also reported being touched sexually (9.4%); living with an adult who abused drugs (7.9%); and 4.1% were forced to have sex. The ACE-affected experienced significantly (p