Minnesota ACEs Prevention & Surveillance (MAPS) - The impact of ACEs on Minnesota (MN) youth and adults is a serious public health concern. According to the 2022 Minnesota Student Survey (MSS), 47.3% of MN 8th, 9th, and 11th grade students reported one or more ACE, with significant differences based on geography, socioeconomic status, race/ethnicity, sexual/gender identity, and ability. African American/Black and American Indian students reported significantly more ACEs than White students. ACEs also tend to co-occur, with 23.8% of students reporting two or more ACES. The strong dose-response association between the number of ACEs and a range of health behaviors make preventing ACEs a priority to multiple divisions of the Minnesota Department of Health (MDH). When compared with students who reported no ACEs, students with four or more ACEs were significantly more likely to report alcohol, marijuana, and prescription drug misuse, as well as mental health outcomes including anxiety, depression, and suicide ideation and attempt. The Minnesota ACEs Prevention and Surveillance (MAPS) project will leverage multisector partnerships and resources to improve and sustain an ACEs and PCEs surveillance system that provides data to identify health inequities, inform ACEs prevention strategies across the state, and improve health equity across the state. This project will: 1) enhance our existing state surveillance infrastructure for ACEs and PCEs (called the Dashboard), which currently uses primarily data from the MSS, to include new and innovative data sources for social determinants of health (SDOH) that will be linked to student data at the county level; 2) implement evidence-based strategies that focus on strengthening economic supports for families and connecting youth to caring adults and activities to prevent ACEs; and 3) use the Dashboard to inform selection and implementation of evidence-based strategies in communities at greatest need. MDH aims to use a data to action framework and to create an effective and efficient surveillance system to collect, analyze, and use ACEs and PCEs data among youth that inform development of new or the adjustment of existing programs and policies. Our long-term goals include preventing ACEs now and in future generations to break the intergenerational cycle of ACEs and preventing further trauma among those who already experienced adverse events by building protective factors in their lives. MDH is proposing to implement the enhanced activities in all three goal areas: In goal 1 we will link SDOH data to MSS data at the county level. The MSS has included the core ACEs questions as well as the three core PCEs questions for the past 4 survey rounds (i.e., 2013, 2016, 2019, 2022). In addition, the Syndromic Surveillance program is housed within the MDH Injury and Violence Prevention Section, and the MAPS team will work with CDC and MDH colleagues to track standard case definitions for ACEs-related indicators. In goal 2, the MAPS project will include prevention activities at the local level as well as bringing together multi-sectoral partners to prevent ACEs and promote PCEs. Goal 3 will include activities to use local data to inform the focus and implementation of prevention strategies, with an emphasis on addressing disparities. Finally, the data to action activities will use linked SDOH and student data to evaluate all the surveillance and prevention activities. MDH will work to measure and meet the short-term outcomes outlined in the CDC Logic Model after Years 1-2 and change in intermediate outcomes in Years 3-5. We look forward to learning and practicing with the CDC and other state grantees as we move Minnesotans on the trajectory toward healing and health.
