Associations between childhood socioeconomic characteristics, race, and risk of adverse childhood experiences in a population-based sample of US-born non-Hispanic Black and White women

Abstract

Background

Socioeconomically disadvantaged and racially minoritized populations bear an elevated risk of adverse childhood experiences (ACEs), but few studies evaluate whether racial disparities in ACEs persist within socioeconomic strata. We examine the effect of both childhood socioeconomic characteristics and race on ACE burden.

Methods

Data are from a population-based sample (N = 1381) of US-born non-Hispanic Black (NHB) and White (NHW) women aged 20–49 years in Metropolitan Detroit and Los Angeles County, 2011–2014. Recalled data on ACEs aged < 13 years, childhood household socioeconomic position (chSEP) aged < 13 years, childhood neighborhood poverty rate (cNPR) aged 6 years (based on US Census tract), and covariates were collected during in-person interviews. ACEs are parameterized as an index (i.e., number of adversities, range 0–12) and as individual adversities. We estimate associations between cNPR (≥ 20%/10- < 20%/< 10%), chSEP index (low/medium/high), race (NHB/NHW), joint cNPR/race, and joint chSEP/race and ACEs using weighted logistic regression, to calculate odds ratios (OR), and using weighted zero-inflated Poisson regression, to calculate estimated ACE index.

Results

Participants who lived in poorer neighborhoods (i.e., cNPR ≥ 20%) or households (i.e., low chSEP index) during childhood reported significantly more ACEs than participants in wealthier neighborhoods (i.e., cNPR < 10%) or households (i.e., high chSEP index). NHB vs NHW participants overall had a higher mean ACE index (3.18 vs 2.25, respectively, p < 0.05), but NHB and NHW participants who lived in poorer neighborhoods or households had a similarly elevated ACE burden (e.g., estimated ACE index for low chSEP was 3.63 [95%CI 1.19–4.97] and 4.16 [95%CI 3.68–4.65], respectively). NHB participants experienced significant discrimination at all levels of cNPR and chSEP, which contributed to their overall increased ACE risk.

Conclusions

US-born NHB and NHW girls residing in poorer neighborhoods or households had a similarly substantially elevated burden of ACEs, indicating childhood poverty is a crucial determinant of ACE risk, independent of race.