Adverse childhood experiences are associated with poverty, and public benefit programs are increasingly used as primary prevention for negative child outcomes. To estimate the association between spending on benefit programs and cumulative exposure to ACEs among children. Children aged 0–17 years in the United States during 2016–17 as reported in National Survey of Children's Health. We examined the sum of state and federal spending on 5 categories of public benefit programs at the state-level. The primary exposure was mean annual spending per person living below the Federal poverty limit across 2010–2017 Federal fiscal years. The primary outcome was children <18 years old having ever been exposed to ≥ 4 ACEs. Nationally, 5.7 % (95 % confidence interval [CI] 5.3 % - 6.0 %) of children had exposure to ≥ 4 ACEs. After adjustment for children's race and ethnicity, total spending on benefit programs was associated with lower exposure to ≥ 4 ACEs (odds 0.96 [95 % CI: 0.95, 0.97]; < 0.001). Increased spending in each individual benefit category was also associated with decreased cumulative ACEs exposure (all < 0.05). Inverse associations were largely consistent when children were stratified by race and ethnicity and income strata. Investments in public benefit programs may not only decrease poverty but also have broad positive effects on near- and long-term child well-being beyond the programs' stated objectives. Findings support federal and state efforts to prioritize families' economic stability as part of a public health model to prevent ACEs.

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用于公共福利计划的支出和不良童年经历的暴露

不良的童年经历与贫困有关，公共福利计划越来越多地被用作不良儿童后果的一级预防。评估儿童福利计划支出与 ACE 累积暴露之间的关联。根据国家儿童健康调查报告，2016-17 年美国 0-17 岁儿童。我们研究了州和联邦在州级 5 类公共福利项目上的支出总和。主要风险是 2010-2017 联邦财政年度生活在联邦贫困线以下的人均年支出。主要结局是<18岁的儿童曾经接触过≥4种ACE。在全国范围内，5.7%（95% 置信区间 [CI] 5.3% - 6.0%）的儿童接触过 ≥ 4 种 ACE。对儿童的种族和族裔进行调整后，福利计划的总支出与 ≥ 4 种 ACE 的暴露程度较低相关（比值 0.96 [95% CI：0.95，0.97]；< 0.001）。每个福利类别支出的增加也与累积 ACE 暴露的减少相关（全部 < 0.05）。当儿童按种族、民族和收入阶层进行分层时，负相关关系基本上是一致的。对公共福利计划的投资不仅可以减少贫困，而且还可以对儿童的近期和长期福祉产生广泛的积极影响，超出计划的既定目标。研究结果支持联邦和州努力优先考虑家庭的经济稳定，作为预防 ACE 的公共卫生模型的一部分。