More than 40 percent of Hawaii children have experienced trauma including the death, divorce or incarceration of a parent, and violence, drug abuse or mental illness in the home, a federal study shows.

The state-by-state survey from the 2016 National Survey of Children’s Health found that 43.2 percent of children under age 18 have had at least one so-called adverse childhood experience, while 21.4 percent have had two or more experiences such as living with someone who is suicidal or has drug or alcohol problems.

Trauma can seriously affect a child’s health and well-being by “contributing to high levels of toxic stress,” the study said. That could increase long-term risk for smoking, alcoholism, depression, heart and liver diseases and other conditions.

Nationally, 33 percent of U.S. children with two or more negative experiences have a chronic health condition, compared with 13.6 percent of children who have not had exposure. More than 46 percent of American kids — 34 million — have had at least one traumatic event.

“Every child deserves a healthy start. A loving home, a good school, a safe neighborhood … the foundation for a long and happy life,” Richard Besser, president and CEO of the Robert Wood Johnson Foundation, which funded the study, said in a news release.

For more information on the report, go to www.cahmi.org.