Using Data-Driven Strategy to Prevent ACEs and Improve Health Outcomes

July 07, 2026 | Rachel Scheckman

Adverse childhood experiences (ACEs), suicide, overdose, and mental health-related concerns are linked across the life course. Early exposure to ACEs raises the risk of later suicide and overdose. In contrast, protective factors, such as positive childhood experiences (PCEs), lower these risks. Strategies that prevent ACEs and promote PCEs also help to prevent suicides, overdoses, and other mental health-related concerns.

State, territorial, and freely associated state health agencies are uniquely positioned to collect data related to the intersection of these public health issues and make it accessible. ASTHO held discussions with Missouri, Michigan, and Tennessee about their data strategies, which helped these states better understand where prevention efforts were most needed. They also emphasized the importance of making data more usable, accessible, and timely for stakeholders.

Missouri: Improving Data Integration and Usage

The Missouri Department of Health and Senior Services (MDHSS) works at the intersection of ACEs, overdose, suicide, and mental-health-related concerns, starting as a deliberate shift toward a life course and spectrum of prevention framework. MDHSS aligned its Maternal and Child Health Services, Substance Use Disorder Grant Program, and Overdose Data to Action Programs to focus on shared risk and protective factors rather than isolated outcomes. This has allowed the state to move some of their work upstream by addressing social drivers alongside its overdose and injury prevention work.

Data integration was an important part of these efforts. MDHSS developed a Social Drivers of Health dashboard that links several of the state’s public-facing dashboards (i.e., their maternal and child health, drug overdose, WIC, and other datasets). This dashboard lets users explore how housing instability, poverty, and SNAP participation intersect with health outcomes at the county level. By visualizing these connections, the dashboard helps stakeholders identify intersecting issues and target interventions more effectively.

MDHSS designed its Social Drivers of Health dashboard to be easily understood by non-epidemiologists, enabling users to “connect the pieces” and identify next steps. By allowing exploration of county-level indicators and health outcomes, the dashboard helps local partners, policymakers, and community organizations identify priority areas, allocate resources, and track progress, supporting evidence-based decision-making and targeted action planning.

Preliminary data show that in 2025, Missouri saw a 26% decrease in drug overdose deaths, continuing a trend that started in 2023. MDHSS achieved this, in part, by improving its data integration and use to guide its prevention and response efforts. 

"It's easy sometimes to leave surveillance where it is, or you have this dashboard that you use, or you're able to present about, but we want [other] people to understand those intersectionalities and understand where [to] follow the data to make the most impact. Our dashboards are a good first step for that, and a good foundation for folks." 

Michigan: Increasing Data Accessibility

The Michigan ACE Initiative started as a grassroots initiative to increase ACEs awareness. It has since grown into a statewide, cross-sector effort to prevent ACEs by addressing suicide, overdose, and other mental and physical health-related concerns. This effort includes the development of a data dashboard that has helped state and local partners identify and prioritize community needs, and drive strategy using a shared and complete understanding of the factors driving health outcomes.

The Michigan Public Health Institute (MPHI), with funding from CDC and in partnership with several Michigan-based organizations (e.g., Michigan Department of Health and Human Services, the Michigan Department of Education, the Michigan ACE Initiative, Central Michigan University, the Children Trust Michigan, and Youth United-Michigan), developed the MI ACE Data Dashboard. The dashboard integrates Michigan-specific data from multiple sources, including the Youth Risk Behavior Survey, Behavioral Risk Factor Surveillance Systems, Michigan Youth Tobacco Survey, Kids Count Data Center, and real-time syndromic surveillance. By bringing this information together, it enables users to identify trends, pinpoint the needs of specific populations, allocate funds, and design focused public education campaigns to prevent and address ACEs, suicide, and other mental health-related concerns.

In addition to developing the dashboard, MPHI has worked closely with partners in the Michigan Department of Education to add ACE-related questions to the Youth Risk Behavior Survey and Michigan Youth Tobacco Survey. The addition of these questions helps Michigan track the prevalence of ACEs over time and better understand differences across communities in the state.

MPHI’s approach democratizes data, making it both accessible and usable to the public at large. The MI ACE Data Dashboard offers user-friendly visualizations and clear, actionable data summaries, enabling users to examine trends in risk factors by community. The dashboard helps pinpoint high-risk areas, prioritize needs, and monitor changes over time. MPHI also supports users through outreach and education, allowing communities to leverage the information to identify emerging issues and implement local prevention strategies. Over time, this approach has empowered groups across the state to spot emerging issues and take action. 

“Data being available is not the same as data being accessible. We have put a lot of effort into sharing and displaying data in our dashboard in a way that is actionable for communities. They don’t have to go to somebody to explain what this means so that [they] can go do something important with it.”

Tennessee: Identifying More Timely Data

In 2019, the Tennessee Department of Health (TDH) partnered with the Tennessee Suicide Prevention Network and other community organizations to form a suicide data workgroup, with the goal of closing gaps in and identifying more timely data on suicide in the state. This partnership led to the adoption of the Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE) system and a focus on early detection and prevention.

ESSENCE monitors trends in suicide attempts, self-harm, and related emergency department visits across the state, alerting local areas when there is an uptick in suicide-related behaviors. This work has given TDH near-real-time insights into increases in these behaviors across the state, enabling them to generate alerts for partnering organizations (e.g., local health agencies, schools, law enforcement, and community organizations). TDH then works closely with these partners to implement response plans focused on prevention and intervention strategies.

TDH’s strategy focuses on the timeliness of data and dissemination to partners, but it does not directly integrate other datasets. Instead, TDH works closely with local partners to interpret what they are seeing and identify potential upstream drivers of suicide using data to inform prevention strategies related to bullying, social isolation, or other unmet needs. They generate weekly ESSENCE alerts and share them with partnering organizations that are positioned to implement interventions locally while risks are still emerging.

ESSENCE has allowed TDH to identify geographic and seasonal spikes in suicide-related behaviors and better react. One notable success has been the use of this data to detect a recurring late summer increase in youth suicide-related emergency room visits. TDOH has responded by launching strategic multimedia prevention campaigns targeting key risk factors (i.e., social isolation, bullying, and other behavioral health needs) in the high-risk counties where this trend was observed.

“We’ve done a really great job on having really timely, actionable data that people can respond to in real time.”

Conclusion

In Missouri, Michigan, and Tennessee, teams worked to build data systems that intentionally communicate data about the shared risk and protective factors that cut across topic areas and organizational silos — ACEs, suicide, overdose, and mental health-related concerns. These examples reinforce that intersecting problems require intersecting data that draws from multiple sources and presents a coherent picture for decision-makers.

Making data timely, accessible, and user-friendly helps ensure that partners at every level —state programs, local coalitions, schools, community organizations, and policymakers — can identify priorities, focus resources, and monitor progress over time. At the same time, data is only one part of the story: Sustained progress depends on supportive policies, sufficient funding, trusted cross-sector partnerships, and a workforce with the capacity to translate information into action.