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Adverse childhood experiences (ACEs) are a public health crisis characterized by detrimental intrafamilial events before the age of 18. Prior studies have linked various factors, including poverty, food insecurity, lack of education, unemployment, living in deplorable conditions, and other socioeconomic problems with physical and mental health-related problems. Using the socioecological framework, this study examines individual, family, and community-level factors associated with cumulative ACEs for children in the United States.
Methodology
Data for this study came from the 2022 National Survey of Children's Health (NSCH), a cross-sectional, web-and-paper-based survey of non-institutionalized U.S. children ages 0–17. The overall sample of 54,103 children ( average age 8.6 years) was utilized. The dependent variable is cumulative ACEs, which was summed up from 11 items coded as binary(0= no ACEs, and 1= one or more ACEs). The independent variables included individual level (child's sex, age, race/ethnicity), family level (number of children in the household, household education, parental employment status, household structure, and language), and community level factors (resident type and neighborhood conditions) all were measured as categorical variables. Multivariate logistic regression was used to determine the significant association between independent and dependent variables while controlling for other factors in the model.
Results
Based on the parents' reports, 31.8% of children had one or more ACEs. After controlling for other factors, children aged 6 -11 (AOR =2.76, p<.001), aged 12 -17 (AOR =5.45, p<.001), and children from households with at least four children (AOR =1.31, p<.001), completed high school (AOR =1.53, p<.001), completed some college/associate degree (AOR =1.95, p<.001), parents unemployed (AOR =1.09, p<.05), two parents unmarried (AOR =3.45, p<.001), single mothers (AOR =8.75, p<.001), another type of families (AOR =11.60, p<.001) were associated with higher odds of experiencing one or more ACEs. However, children from households with a family income 400% or above the federal poverty level (FPL) (AOR =0.79, p<.001), speak Spanish (AOR =0.60, 95% CI= 0.52– 0.69, p<.001), or other languages (AOR =0.45, p<.001) had lower odds of experiencing one or more ACEs. Additionally, children living in metropolitan areas had lower odds of experiencing one or more ACEs compared to children living in non-metropolitan areas (AOR =0.94, p<.05). Finally, children living in neighborhoods that are poorly rundown or poorly kept housing had 1.96 times higher odds of experiencing one or more ACEs compared to those who did not (AOR =1.96, 95% CI= 1.81 –2 .12, p<.001).
Conclusions and Implications
This study reinforces previous findings associating multidimensional poverty with poorer outcomes for children. Results indicated households speaking Spanish or a language other than English as the primary language had reduced odds of experiencing ACEs, demonstrating potential protective factors within these households. Future research should explore the relationship between acculturation, assimilation, and the presence of ACEs, as well as potential individual, family, and community protective factors for non-English speaking households. Results indicated lower odds for ACEs in metropolitan areas, contradicting common perceptions of trauma within urban environments. This may reflect limitations of ACEs in capturing broader experiences of trauma within metropolitan settings.