Equity Research Cooperative, 2929 Arch Street Suite 1700-#3207, Philadelphia, PA 19104, USA.
Department of Health Policy, Vanderbilt University School of Medicine, 1211 Medical Center Drive, Nashville, TN 37232, USA.
Int J Environ Res Public Health. 2022 Aug 27;19(17):10670. doi: 10.3390/ijerph191710670.
Children across all races/ethnicities and income levels experience adverse childhood experiences (ACEs); however, historically excluded children and families must contend with added adversities across ecological levels and within higher-risk conditions due to systemic inequality. In this grounded theory study, the authors examined how health and social service providers ( = 81) from rural and urban counties in Tennessee provided services to low-income families, children exposed to opioids, and children of immigrants. Guided by an intersectional framework, the authors examined how rural and urban settings shaped higher risk conditions for ACEs and impeded access to resources at the individual, group, and community levels. Findings from this study identified additionally marginalized subpopulations and demonstrated how inequitable environments intersect and compound the effects of ACEs. The authors present their to showcase the relationship between high-risk conditions and sociopolitical and economic circumstances that can worsen the effects of ACEs. Ultimately, the differentiates between ACEs that are consequences of social inequities and ACEs that are inflicted directly by a person. This framework better equips ACEs scholars, policymakers, and stakeholders to address the root causes of inequality and mitigate the effects of ACEs among historically excluded populations.
所有种族/族裔和收入水平的儿童都经历过不良的儿童期经历 (ACEs)；然而，由于系统不平等，历史上被排斥的儿童和家庭必须在生态层面上应对更多的逆境，并在更高风险的情况下应对。在这项扎根理论研究中，作者研究了田纳西州农村和城市县的健康和社会服务提供者（=81 人）如何为低收入家庭、接触阿片类药物的儿童和移民儿童提供服务。作者以交叉框架为指导，研究了农村和城市环境如何塑造 ACEs 的更高风险条件，并阻碍了个人、群体和社区各级获取资源的机会。这项研究的结果确定了更多处于边缘地位的亚群体，并展示了不平等环境如何相互交叉和加剧 ACEs 的影响。作者提出了他们的 ，以展示高风险条件与社会政治和经济环境之间的关系，这些环境可能会加剧 ACEs 的影响。最终，该 区分了社会不平等造成的 ACEs 和直接由个人造成的 ACEs。这一框架使 ACEs 学者、政策制定者和利益相关者能够更好地解决不平等的根本原因，并减轻历史上被排斥的人群中 ACEs 的影响。
