Neighborhood Characteristics and Resilience Among School-Aged Children with a History of Childhood Adversity

Background and Purpose:
Adverse Childhood Experiences (ACEs)—such as abuse, neglect, and household dysfunction—are associated with poor outcomes across the lifespan, including physical and mental health problems, reduced educational attainment, and social difficulties (Bethell et al., 2019; Felitti et al., 1998; Hughes et al., 2017). However, some children show resilience—defined as positive adaptation despite adversity—reflected through child flourishing and family resilience (Crouch, Radcliff, Bennett, Brown, & Hung, 2024; Masten & Barnes, 2018; Bethell et al., 2014). While individual and family factors contributing to resilience are well studied, the influence of neighborhood environments remains underexplored, particularly among children exposed to ACEs. This study examined the role of neighborhood characteristics in predicting resilience—operationalized as child flourishing and/or family resilience—among school-aged children with ACE exposure in the United States.

Methods:
Data were drawn from the 2019 National Survey of Children’s Health (NSCH), a nationally representative survey of U.S. children. The analytic sample consisted of 8,613 children aged 6–17 who had experienced at least one ACE. Resilience was measured using parent-reported indicators and categorized into four mutually exclusive groups: (1) neither child flourishing nor family resilience (NCFFR), (2) child flourishing only (CFO), (3) family resilience only (FRO), and (4) both child flourishing and family resilience (BCFFR). Multinomial logistic regression models examined the associations between resilience status and neighborhood-level predictors, including school safety, neighborhood safety, social cohesion (supportive neighborhood), physical environment (amenities and distractions), and access to health care.

Findings:
Neighborhood characteristics emerged as significant predictors of resilience. Supportive neighborhoods were positively associated with both FRO (RRR=1.51, p<.05) and BCFFR status (RRR=2.27, p<.001). School safety was associated with increased odds of FRO (RRR=1.82, p<.05) and BCFFR (RRR=2.15, p<.01). Access to a medical home predicted greater likelihood of both CFO (RRR=1.50, p<.05) and BCFFR status (RRR=1.91, p<.001). In contrast, distracting neighborhood conditions were negatively associated with CFO status (RRR=0.58, p<.05). Neighborhood safety and physical amenities did not significantly predict resilience in adjusted models.

Conclusions:
Neighborhood-level social cohesion and perceptions of school safety are strong predictors of resilience among children with ACEs. These findings support Bronfenbrenner’s ecological systems theory, which emphasizes the role of environmental factors in child development (Bronfenbrenner, 1979). Promoting resilience requires interventions that extend beyond the family to address neighborhood and school environments. Community-based strategies—such as strengthening neighborhood networks, improving school safety, and expanding access to integrated healthcare—are essential for supporting children exposed to ACEs. These findings suggest that resilience is not only an individual trait but also a function of the broader socio-ecological environment.