Adverse Childhood Experiences, Victimization, and Perceptions of Formal Help-Seeking Experiences Among Black Adults: Insights from a Statewide Victim Needs Assessment

Background and Purpose: Salient in the literature are disproportionate rates of violence and trauma exposure, unmet physical and mental health needs, and underutilization of formal victim services and supports among Black adults in the U.S. context. However, there is a gap in knowledge concerning the associations between adverse childhood experiences (inclusive of exposure to community violence), lifetime victimization (across varying victimization types), and formal help-seeking experiences among this population. The primary goals of the current study were to understand perceptions of formal help-seeking experiences among Black adults who demonstrate promotive health behaviors following victimization — and to examine the associations between ACEs and help-seeking across diverse types of victimization.

Methods: Data for the current study was extracted from a statewide victim needs assessment that utilized online survey data to analyze needs, facilitators, and barriers to victim-centered services and support across 84 Illinois counties (comprised of urban, suburban, and rural geographic areas). Survey data was examined from a subgroup of survey respondents who self-identified as African, African American, or Black (n = 402 (61% cisgender female); 36% of the total 1,114 participants) and self-reported the utilization of formal, informal, or a mix of formal and informal services and supports following victimization. We examined descriptive statistics to explain the sample; conducted correlation, crosstabs and chi-square tests to examine frequencies of ACEs and lifetime victimization; and conducted multivariate logistic regression to examine associations between ACEs and help-seeking.

Results: High rates of ACEs and lifetime victimization across forms of violence and crime were reported. Approximately 76% of respondents experienced at least one ACE, a staggering 93% reported at least one form of victimization in their lifetime, and over 75% of respondents sought formal victim services and support. There were significant associations between ACEs and types of help-seeking that were sought. For example, higher levels of ACEs were associated with greater odds of seeking a mixture of formal and informal supports (compared to just formal or just informal supports). Additionally, higher levels of ACEs were associated with more perceptions of negative formal help-seeking experiences (B = 0.091). Among covariates, participants from urban geographies were more likely to perceive negative formal help-seeking experiences (B = 0.366).

Conclusions and Implications: The current study provides keen insight into the potentially negative experiences of Black adults who demonstrate promotive health behaviors and utilize formal community-based services and supports. These experiences may act as a significant barrier to utilization of formal services and supports and exacerbate disparities in treatment seeking experiences among this population. This research contributes to growing research on disparities in health and mental health care utilization. These findings strongly emphasizes the need to further examine diverse victimization experiences and deeply consider the historical context among Black adults in disparities research and community level practice.