Adverse Childhood Experiences and Involvement in Physical Activities Among Racial/Ethnic Minority Children in the U.S

Background and Purpose: Adverse childhood experiences (ACEs) have been shown to increase the risk of health problems in children and later in life, with evidence indicating that their impact differs across racial and ethnic groups. While physical activity plays an important role in contributing to health and well-being, exposure to ACEs may reduce children's participation in such activities. This study investigates the prevalence and association between ACEs and involvement in physical activities among children from racial/ethnic minority groups in U.S.

Methods: This study derived data from the 2023 National Survey of Children’s Health (n=8,126; racial/ethnic minority children aged 6-17). The dependent variable, which is involvement in physical activities, was assessed by asking parents: “During the past week, did this child participate in physical activity for at least 60 minutes? “ This was dichotomously coded as “lower” (<=4 days) and “higher” (=> 5 days or every day). Adverse childhood experiences (ACEs) served as independent variables that captured lifetime exposures to nine experiences: financial hardships, parental divorce/separation, parental incarceration, parental death, a child witnessing parental domestic violence, a child being a victim/witnessing neighborhood violence, co-residing with an adult in the household who suffers from mental illness or substance use, witnessing domestic violence, and experiencing discrimination. We summed up all nine binary responses (no/yes), constructing a measure indicating whether a child experienced: 0 ACE, 1 ACE, or 2 or more ACEs. Covariates included the child's sex, age, race/ethnicity, BMI, health status, parental education, family structure, and mental health conditions. Chi-square tests estimated weighted prevalences and two sets of logistic regression models (unadjusted and adjusted) assessed the association between ACEs and higher involvement in physical activities. Data analysis was performed using SPSS vs. 29 (p< .05).

Results: Out of the 8,126 children, 45% were involved in physical activities for at least 60 minutes during the past week. The prevalence of higher involvement in physical activities was lower for children with two or more ACEs (42.8%), followed by those with at least one ACE (43.6%) and without ACEs (46.7%), respectively. In an unadjusted regression model, children with at least one ACE (aOR=0.88, 95% CI=0.79–0.99, p=0.026) and two or more ACEs were significantly associated with decreased odds of being involved in physical activities compared to children without ACEs (aOR=0.86, 95% CI=0.76–0.96, p=0.006). In the fully adjusted model, exposure to two or more ACEs was significantly associated with a lower likelihood of higher involvement in physical activities compared to those without ACEs (aOR=1.57, 95% CI=1.15–2.16, p<.001). However, exposure to at least one ACE was not significantly associated with higher involvement in physical activities among racial/ethnic minority children (aOR=1.01, 95% CI=0.89–1.15, p=0.86).

Conclusion: This study shows that racial/ethnic minority children with two or more ACEs are less likely to be involved in regular physical activities. Interventions should use trauma-informed approaches to address the effects of ACEs. Physical activity should be integrated into supportive spaces like schools and community centers. Family support and mental health access can further help reduce adverse outcomes associated with ACEs.