Statement of Purpose Prevalence of mental health problems among U.S. youth has increased in recent years, and there is a dearth of epidemiological research at the state level that integrates risk and protective factors into population-based surveillance. We utilized the developmental assets framework to measure protective factors; we assessed (1) prevalence of depressive symptoms, high adverse childhood experiences (ACEs; ≥4 ACEs—including child maltreatment and abuse), and few developmental assets (≤2 assets) over time, and (2) associations among these three phenomena.

Methods/Approach Using 2016 and 2019 Minnesota Student Survey data, we utilized descriptive statistics, logistic regression and post-estimation analyses. We examined how high ACEs and few assets predict depressive symptoms and tested three-way interactions for high ACEs, few assets, and survey year.

Results There were statistically significant increases in prevalence of depressive symptoms, high ACEs, and few assets between 2016 and 2019. High ACEs (AOR=2.74; 95% CI=2.61, 2.89), and few assets (AOR=3.13; 95% CI=3.00, 3.26) were positively related to depressive symptoms; interactions were statistically significant. Additive interactions showed that adolescents with high ACEs and few assets had the highest prevalence of depressive symptoms, and this group exhibited the largest increase in prevalence between 2016 and 2019.

Conclusion Depressive symptoms are highest among adolescents with high risk and few protective factors, and recent increases in the prevalence of depressive symptoms appear to have disproportionately occurred among these adolescents. We offer a potential roadmap for following Centers for Disease Control and Prevention (CDC) recommendations to integrate ACEs and protective factors into local public health efforts.

Significance The CDC has called for systematic efforts to integrate ACEs and protective factors into state and local public health surveillance focused on violence and injuries. This project offers a roadmap for addressing these calls, relying on the DAF to measure and assess protective factors for positive youth outcomes.