NSSP Adverse Childhood Experiences Dashboard Best Practices Document

How can syndromic surveillance be used to monitor indicators of ACEs?

Scientists at CDC’s Division of Violence Prevention and at health departments across the country are exploring the utility of syndromic surveillance data to monitor indicators of ACEs among pediatric populations and household or community challenges among adults to get a better sense of trends in indicators of ACEs in near real-time. Using existing National Syndromic Surveillance Program (NSSP) syndrome definitions that map onto well-recognized ACEs (e.g., CDC Suspected Child Abuse and Neglect v1 definition), syndromic surveillance data can be used to monitor macro-level trends in visits related to ACEs at a local, state, and national level. Syndromic surveillance can directly measure ACE indicators through ED visits involving children (e.g., child abuse and neglect, homelessness), and indirectly through measurement of conditions affecting adults (e.g., substance use, intimate partner violence) as a proxy for household or community challenges that constitute ACEs. Syndromic surveillance data can also be used to track trends in potential outcomes related to experiencing ACEs, such as mental health conditions, suicide-related outcomes, drug overdose, and alcohol misuse among children and adolescents.

There are several advantages to syndromic surveillance. The first advantage is timeliness: syndromic surveillance data are often available within 24 hours. NSSP also has broad geographic coverage, covering nearly 75% of US emergency departments, continually improving data quality, and plans to expand to additional participating facilities in 2023 and beyond (Figure 1).1 Next, the NSSP analytic platform allows users to overlay syndromes to identify comorbidities. For example, indicators for individual ACEs like suspected child abuse and neglect (CAN) can also be examined in conjunction with visits related to intimate partner violence (IPV), mental health conditions, and drug overdose or alcohol misuse.

Scientists and public health practitioners across the country have collaborated to develop an ACEs dashboard within the NSSP analytic platform to monitor trends in ACE indicators, household and community challenges among adults, and potential outcomes related to ACEs.