Investigating Racial Differences in Clusters of Adverse Childhood Experiences

Background and Purpose:

In the late 1990s, Felitti and colleagues (1998) released the groundbreaking findings from the Adverse Childhood Experiences (ACEs) study, which examined the impact of negative life events occurring in childhood on adult health. The current study seeks to understand whether there are racial differences in combinations of ACEs experienced in a nationally representative dataset of children. The racial differences in rates of individual types of ACEs as well as the number of ACEs experienced suggests that there may be important differences in the combinations of ACEs experienced.

Methods:

Data was drawn from the 2016 National Survey of Children’s Health (NSCH). The NSCH is nationally representative data set of all youth in the U.S. and was collected by the U.S. Census Bureau. Bivariate and descriptive analyses examined the exposure to specific ACEs by total ACEs and the exposure to at least 1 ACE by child age. Last, we conducted a combination analysis to examine the combinations of specific ACEs by total cumulative ACEs. To assess configural similarity, we estimated three separate LCAs, one for each racial/ethnic group. LCA was performed using Mplus 7.4. LCA is an iterative approach in which models are estimated in succession and the model with the best model fit is selected. 

Results:

We found that there were significant differences in the experience of children by race. In our sample, White children had lower exposure to each individual ACE except parental mental health and substance use disorders and had lower counts of ACEs overall.

As children get older, their likelihood for experiencing ACEs increases, as they have more time to have had such experiences. Within our sample of children, a similar percentage of Black children (45%) had experienced one ACE compared to White children (43%) who were age 10.

In terms of the types of ACEs experienced, there was also significant variation by race. Over time, White children were more likely to have experienced having a parent with a drug and alcohol problem compared to Black and Hispanic children who were much more likely to have experienced neighborhood violence or racial discrimination. Black children also had higher rates of having a parent who was incarcerated.

In addition to the differential experiences by race, this study also shows critical commonalities in experiences of adversity across races of children in the United States. More than 1 in 5 White children, 1 in 4 Hispanic children, and 1 in 3 Black children in this nationally-representative sample of children in the United States lived in households in which the family had difficulty making ends meet.

Conclusions and Implications:

The past two decades have resulted in a proliferation of research suggesting the important link between ACEs and health. A critical next step in this work is to understand how different combinations of experiences differentially relate to health outcomes, and how these experiences differ by an individual’s background. This information is vital for understanding the interventions that can be put in place.