ACEs, Races, and Poverty: Racial/Ethnic Differences in Self-Reported Childhood Adversity in a Low-Income Sample

Background: Research indicates that adverse childhood experiences (ACEs) are especially prevalent among low-income groups and certain racial/ethnic minority groups in the U.S. It is not clear, however, whether racial/ethnic differences in self-reported adversity manifest after accounting for the effects of income.

Methods: This study is a secondary analysis of data collected from a diverse sample of 1,225 low-income women that received home visiting services in Wisconsin. Participants completed a standard assessment of ACEs, including five child maltreatment items and five household dysfunction items. The 10 items were dichotomously coded and summed into a total ACE score (range 0-10), representing the focal study outcome. Participants were coded into five dichotomous racial/ethnic categories: Non-Hispanic White, Non-Hispanic Black, Non-Hispanic American Indian, “Other” race/ethnicity, and Hispanic.  

Descriptive analysis of study measures and bivariate tests of association between race/ethnicity variables and the total ACE score were conducted using SAS version 9.4. Preliminary analysis using a random intercept hierarchical model indicated that participants’ home visiting program accounted for less than 3% of variation in total ACE scores. The two-level model also was over-specified once fixed effects were introduced, suggesting that effects are not nested within programs. Therefore, we used Ordinary Least Squares regression to test for differences in ACE scores among racial/ethnic groups, controlling for program-level differences and four other self-reported adversities: chronic family financial problems, food insecurity, homelessness, and prolonged parental absence.

Results: The racial/ethnic composition of the sample was 33.6% White, 26.9% Black, 22.5% Hispanic, 9.0% “Other” race/ethnicity, and 8.1% American Indian. Omnibus tests uncovered significant racial/ethnic differences in total ACE scores as well as 7 of the 10 individual ACE items at the .01 alpha level. Among all racial/ethnic groups, White respondents reported the highest mean ACE score (µ = 3.8), followed closely by American Indian respondents (µ = 3.7). Mean ACE scores were substantially lower among Black (µ = 2.9) and Hispanic (µ = 2.8) respondents. Multivariate analysis confirmed that, controlling for individual and program differences, mean ACE scores were significantly higher for White participants than for either Black (p < .01 ) or Hispanic (p < .01 ) participants.

Conclusions and Implications: In the general population, certain racial/ethnic minority groups appear to be at an elevated risk of exposure to ACEs. However, in a low-income sample of women we discovered ACE prevalence rates that were significantly higher for non-Hispanic Whites than for non-Hispanic Blacks and Hispanics. Our findings reinforce recent results from the National Survey of Child Health, a large-scale, nationally representative study. The authors found that overall ACE rates were higher among Blacks and Hispanics than Whites, but within the lowest-income stratum ACEs were significantly more prevalent among Whites than Blacks and Hispanics (Slopen et al., 2016). Explanations and implications of these unexpected findings will be discussed.

Reference:  Slopen, N., Shonkoff, J. P., Albert, M. A., Yoshikawa, H., Jacobs, A., Stoltz, R., & Williams, D. R. (2016). Racial disparities in child adversity in the US: Interactions with family immigration history and income. American Journal of Preventive Medicine, 50(1), 47-56.