State YRBS finds higher ACE scores linked to depression, suicide risk and bullying among Oklahoma youth
February 01, 2024 | Oklahoma Commission on Children and Youth, Executive, Oklahoma
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Thad Burke, a child epidemiologist at the state health department, presented new analysis of Adverse Childhood Experiences (ACEs) added to the Youth Risk Behavior Survey (YRBS). The agency analyzed responses from 50 randomly selected public schools (grades 9–12); the ACE analysis was limited to respondents age 17 and younger.
Burke explained the survey methodology and coding (13 ACE questions combined into an 11-point composite for scoring). He said respondents were grouped by number of ACEs (0, 1, 2–3, 4 or more) and that prevalence of several risk indicators rose with ACE count. For example, students with four or more ACEs had substantially higher prevalences of depression and suicide risk (Burke cited a figure near 69% for depression among those with 4+ ACEs) and were more likely to report bullying and substance use. Burke cautioned that the YRBS is cross-sectional and correlational: it measures associations but does not prove causation.
Commissioners raised questions about parental consent for anonymous classroom surveys and whether parental non-consent might undercount the most at-risk children. Burke explained the use of passive consent (letters sent home; students participate unless a parent signs and returns an opt-out) is an IRB requirement for sensitive topics to protect students and ensure sufficient participation; he also noted the survey's classroom-based anonymous administration and an effective response rate around 82% of students present. Commissioners also asked why certain hard-drug items were omitted in 2023; Burke said those items were dropped in 2023 to make room for ACEs items because their prevalence had fallen below thresholds the state uses to track (most below 5%), but he said the department may reintroduce some items.
Burke concluded that even with potential undercounting the results show ACEs are present and correlated with several adverse outcomes; he said the department will publish further analysis and expects two years'worth of ACEs data to aid trend analysis.
Source: YRBS/ACEs presentation and Q&A recorded at the June 21 commission meeting.
Burke explained the survey methodology and coding (13 ACE questions combined into an 11-point composite for scoring). He said respondents were grouped by number of ACEs (0, 1, 2–3, 4 or more) and that prevalence of several risk indicators rose with ACE count. For example, students with four or more ACEs had substantially higher prevalences of depression and suicide risk (Burke cited a figure near 69% for depression among those with 4+ ACEs) and were more likely to report bullying and substance use. Burke cautioned that the YRBS is cross-sectional and correlational: it measures associations but does not prove causation.
Commissioners raised questions about parental consent for anonymous classroom surveys and whether parental non-consent might undercount the most at-risk children. Burke explained the use of passive consent (letters sent home; students participate unless a parent signs and returns an opt-out) is an IRB requirement for sensitive topics to protect students and ensure sufficient participation; he also noted the survey's classroom-based anonymous administration and an effective response rate around 82% of students present. Commissioners also asked why certain hard-drug items were omitted in 2023; Burke said those items were dropped in 2023 to make room for ACEs items because their prevalence had fallen below thresholds the state uses to track (most below 5%), but he said the department may reintroduce some items.
Burke concluded that even with potential undercounting the results show ACEs are present and correlated with several adverse outcomes; he said the department will publish further analysis and expects two years'worth of ACEs data to aid trend analysis.
Source: YRBS/ACEs presentation and Q&A recorded at the June 21 commission meeting.
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