Ranking and Visualizing Clusters of the US States by Adversity Childhood Experiences

Abstract

Adverse Childhood Experiences (ACEs) refer to traumatic childhood events like emotional, physical, sexual abuse, and other forms of household dysfunction. ACEs are associated with biomarkers for chronic diseases resulting in early mortality and increased morbidity. According to the Centers for Disease Control and Prevention, ACEs are common: Around 61% of adults across 25 US states reported having experienced at least one type of ACE. Ranking and finding clusters of the US states on ACEs provide a better understanding of the situation and helps prevent or reduce the occurrence of ACEs. The paper aims to apply a Multiple Criteria Decision-Making Model called the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) method and calculate the overall Composite Index‘ to rank the states. Furthermore, the study uses the K-Means Cluster algorithm to identify and visualize clusters of states experiencing similar ACEs. The BRFSS 2019 data set was used for all analyses. The TOPSIS method suggested that Tennessee had the worst status of ACEs (ranked first) and North Dakota performed the best (ranked last). The elbow method determined that four clusters were present out of the 21 states. Many states ranked with the highest ACEs were clustered together: Tennessee, Florida, Pennsylvania, New Mexico, Delaware, Michigan. To better understand the current performance of the US regarding ACEs, it would be best to collect data from all states. Diagnostic studies, such as this study, can create the foundation for addressing and eradicating child maltreatment and ensuring healthy and nurturing childhoods.