Adverse Adult Experiences: Racial and Ethnic Variation in a Low-Income Sample of Women

Background and Purpose: Adverse childhood experiences (ACEs) are highly prevalent in low-income and racial/ethnic minority groups. Yet, recent studies indicate that low-income Whites report more ACEs than do low-income Black and Hispanic (i.e., Latinx) groups, while the harmful effects of ACEs are largely consistent throughout the population. Using data from a panel study of low-income women, we conducted the first investigation of racial/ethnic differences in the prevalence, interrelation, and consequences of adverse adult experiences (AAEs).

Methods: Data originated from the Families and Children Thriving study, a longitudinal investigation of low-income families in Wisconsin. The current analysis included 1,700 women who completed the Adult Experiences Survey, a seminal assessment of AAEs (Author, 2020). We measured five AAEs that reference a current or former partner/spouse: physical or emotional abuse, sexual abuse, substance abuse, mental health problem, and incarceration. Physical and emotional abuse items were combined because they were highly correlated (phi = .73). Five other adversities were sexual assault, crime victimization, chronic financial problems, homelessness, and discrimination. The 10 AAEs were dichotomized and used to create a composite score.

The prevalence of AAEs was estimated among 434 Hispanic respondents and respondents from three non-Hispanic groups: American Indians (n=107), Blacks (n=345), and Whites (n=814). Categorical confirmatory factor analyses (CFAs) were fit to assess the comparability of latent factor loadings among racial/ethnic groups. Differential item functioning across groups was analyzed using an alignment optimization procedure. Multi-group path analyses were performed to examine racial/ethnic differences in the effects of cumulative adversity on mental health outcomes surveyed approximately one year later. We measured global mental health using a subscale of the PROMIS Global-10, depression with the Patient Health Questionnaire-9, anxiety with the Generalized Anxiety Disorder-7, and posttraumatic stress disorder with the Primary Care PTSD screen. All path analyses controlled for participant age, education, and cohabitation.

Results: Non-Hispanic Whites reported the highest prevalence of physical and emotional abuse, sexual abuse, and sexual assault; American Indians reported the highest prevalence of all other AAEs. Latinx respondents reported the lowest prevalence of all adversities except discrimination. Composite adversity scores were 4.7 for American Indians, 4.1 for Whites, 3.3 for Blacks, and 2.5 for Hispanics.

CFAs showed that a two-factor model (f1 = intimate partner adversities; f2 = other adversities) fit the data well for Whites, Blacks, and Hispanics (CFI > .95, RMSEA < .06, SRMR < .08); American Indians were omitted due to their small sample and cell sizes. Measurement invariance was observed across all racial/ethnic groups for each item except discrimination—White respondents were more likely to report discrimination if they endorsed other AAEs. Path analyses showed the composite adversity score was significantly associated with depression, anxiety, PTSD, and poor global mental health, and there was no evidence that effects varied by race/ethnicity.

Conclusions: Confirming ACE research, AAEs were disturbingly prevalent among American Indians, while low-income Whites reported more adversity than did low-income Blacks and Hispanics. Greater adult adversity predicted poor mental health for all groups. Study limitations and implications for intersectional research and intervention will be discussed.