The Role of Cumulative Adverse Childhood Experiences (ACEs) on Alcohol Use in Adulthood Among Black Men

Background and Purpose: Research has consistently found an association between adverse childhood experiences (ACEs) and alcohol use in adulthood; however, these studies have primarily utilized non-Hispanic White samples. Black individuals tend to have higher rates of ACEs compared to other racial/ethnic groups. Furthermore, although Black men tend to consume less alcohol when compared to their White counterparts, they are at increased risk of experiencing alcohol abuse and dependence due to social and economic disadvantage. Given that ACEs co-occur, this study aims to examine the role of cumulative ACEs on alcohol use in adulthood among a sample of Black men while controlling for sociodemographic factors.

Methods: A sample of 1, 430 Black men aged ≥20 years who were current drinkers were obtained from Wave 2 of the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC). A composite score (0-10) was created for ACEs using 10 items - physical and emotional neglect; physical, emotional, and sexual abuse; witnessing mother/caregiver being abused; having a household member with a mental illness, drug and/or alcohol problem, or who was incarcerated before age 18. Alcohol use in adulthood was measured with one question about daily alcohol consumption. Descriptive and linear regression model predicting alcohol use were run with weighted data using STATA 16.0.

Results: Seventy percent of the sample experienced at least 1 ACE. Specifically, 18.6, 18.1%, 14.2%, and 19.1% reported exposure to 1, 2, 3 and ≥4 ACEs, respectively. On average Black men had a mean ACEs score of 1.94 (SD=2.24) and consumed 0.62 (SD=2.02) standard alcoholic drinks per day. Ordinary least squares regression analysis showed that cumulative ACEs was significantly associated with an increase in alcohol use among Black men (B=0.04, p=.004). Additionally, several covariates were associated with alcohol use among Black men. Age, household income, and marital status were associated with reduced alcohol use, while educational attainment and perceived stress were associated with increased alcohol use.

Conclusion & Implications: This study shed light on the effects of cumulative ACEs on alcohol use in adulthood by Black men. Results indicated that Black men with exposure to more adversities in childhood consumed more alcohol in adulthood. Given the toxicity of exposure to adversities in childhood and its negative impact on the developing brains of children, alcohol may be used as a coping mechanism, especially among this sample of marginalized Black men. Social- and community-level interventions that address the material disadvantage and social isolation which most children with ACEs experience should be developed. Efforts aimed at improving neighborhood environments within which children live, through community development and other forms of intervention, may be effective in reducing health inequities and improving the overall health of children, especially those from racial/ethnic minority groups. Finally, the development of culturally specific and combined interventions to treat Black men who experienced adversities in childhood and alcohol use in adulthood, is of utmost importance.