Study Pinpoints Neighborhoods Where Children Are Most at Risk for Poor Health Outcomes

Growing up in an environment where trauma and toxic stress are present can impact a child’s physical and behavioral health for a lifetime. Where in metropolitan St. Louis are these risks most prevalent?

A recent study by the Missouri Hospital Association’s Hospital Industry Data Institute rates ZIP codes throughout the region on their level of risk according to Adverse Childhood Experiences (ACE), which measure factors that negatively influence a child’s development. ACEs cover domains including psy­chological, physical or sexual abuse; witness of mother’s violent treatment; and household members who were drug or alcohol abusers, mentally ill or suicidal, or ever imprisoned.

The study gathered data on over 200 risk factors including child abuse reports, adult abuse reports, criminal behavior, poverty, mental illness, gun violence and more. The study utilized hospital admission data from 2013 to 2015 as well as various public data sources. More than 200 ICD 9-CM, major diagnostic category and discharge dis­position codes were categorized into 25 measures which were attributed to one of four ACE-related domains: abuse, neglect, household challenges and toxic stress. The entire study area included Missouri, Kansas and 65 Illinois ZIP codes located in the St. Louis metro area.

HIDI Risk Map - St Louis


The 25 worst-ranking ZIP codes in the metro St. Louis area and their index scores are:

63103 1.63
63113 1.33
63120 1.13
63106 1.10
63133 1.02
63115 1.00
63102 0.99
63118 0.96
62059 0.92
63107 0.88
63101 0.83
63111 0.73
63147 0.71
63136 0.63
63140 0.58
63112 0.54
63138 0.48
62204 0.48
63137 0.48
62018 0.45
63121 0.41
63134 0.40
63135 0.36
62090 0.29
63104 0.29

“Mitigating the harm of these ACEs requires that communities identify the drivers of long-term health and social problems, and build community-wide systems to better serve children at risk for ACEs,” the hospital association report said.

The report praised Alive & Well STL for its work in raising community awareness of the consequences of trauma and adversity, building community resiliency and generating a baseline of data-informed evidence.

See the entire study report. For the study data set, visit   The Excel file includes all measures and domains, and a detailed description of measure defi­nitions, including the categorical cod­ing approach.

Thanks to the Missouri Hospital Association for this excellent study!