The Effects of Disability Status and Neighborhood Environment on Adverse Childhood Experiences Among Young Adults

Background & Purpose

Adverse childhood experiences (ACEs) are early traumatic events that can impact a person’s health and well-being, as well as future violence victimization. A growing body of research indicated that ACEs are a critical public health issue. Previous studies reported that individuals with disabilities are at a higher risk for various forms of ACEs, compared with individuals without disabilities. Little research has addressed the impact of disability and community context on ACEs among young adults, and even less is known if, and how, neighborhood environment affects the relationship between disability status and ACEs. The purpose of this study is to examine the direct and indirect pathways between disability status, neighborhood environment during childhood, and ACEs among young adults. Our study tested the following hypotheses: (1) Disability status would exhibit a direct effect on ACEs; (2) Disability status would exhibit an indirect effect through neighborhood environment, which in turn, would be associated with ACEs; (3) Neighborhood environment would exhibit a direct effect on ACEs.

Methods

This study used a quantitative, explanatory research design using a cross-sectional survey. Data was derived from an online survey conducted with samples from seven universities in the U.S. and Canada (N = 2,049) between March 2016 and June 2017. We tested a partial mediation model (i.e., the relationship between disability status and ACEs, which is a latent variable, including peer victimization, exposure to community violence and victimization, child abuse and neglect, and exposure to domestic violence, using the perceptions of neighborhood environment, which is a latent variable, including neighborhood cohesion and safety indicators as a partial mediator), controlling for socio-demographic variables associated with neighborhood environment and ACEs. Data analysis included Pearson correlations and Structural Equation Modeling procedure with Stata 13.

Results

Model fit was determined by using a combination of absolute, incremental, and noncentrality based indices. The hypothesized model shows a good model fit: RMSEA= 0.048, CFI= 0.971, TLI= 0.955, SRMR= 0.034. Given the model’s specification, this study’s three hypotheses are substantiated by the data and it confirmed the partial meditational model, showing neighborhood environment as a partial mediator between disability status and ACEs. In other words, disability status has both the direct effect and the indirect effect through neighborhood environment on ACEs. Additionally, neighborhood environment has the direct effect on ACEs. Having a disability is negatively associated with neighborhood cohesion and safety (ß = -0.10, p< .001) and positively associated with ACEs (ß = 0.22, p < .001). Neighborhood cohesion and safety are negatively associated with ACEs (ß = -0.29, p < .001).

Conclusions & Implications

The findings of the study suggest neighborhood environment such as perceived neighborhood cohesion and safety as a mediator and protective factor between disability status and ACEs among young adults. To fully elucidate the relationship between disability status and a higher risk of ACEs among young adults with disabilities and prevent ACEs that can adversely impact the long-term outcomes of them, greater attention to environmental risk and protective factors, in addition to individual factors, are urgently needed.