Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.
RTI International, Berkeley, CA, USA.
BMC Public Health. 2023 Feb 2;23(1):223. doi: 10.1186/s12889-023-14993-5.
Adverse Childhood Experiences (ACEs) are a measure of childhood toxic stress that have a dose-dependent relationship with many adult health outcomes. While ACEs have been validated across diverse populations to measure neglect, abuse, and family dysfunction, they do not specifically assess trauma related to racism/xenophobia and immigration. 54% of Latinx youth in the United States are immigrants or children of immigrants and a large group with potentially unmeasured trauma. This study looks beyond ACEs to identify adverse and protective factors for healthy development among Latinx youth in an agricultural community through the perspectives of their mothers.
Twenty mothers of adolescent participants in A Crecer: the Salinas Teen Health Study (a prospective cohort study of 599 adolescents) completed semi-structured interviews in Spanish. Interviews focused on mothers' perspectives on community resources, parenting strategies, parenting support systems, and their future aspirations for their children. Four coders completed iterative rounds of thematic coding drawing from published ACEs frameworks (original ACEs, community ACEs) and immigrant specific adverse events arising from the data.
Mothers in this study reported adverse experiences captured within community-level ACEs but also distinct experiences related to intergenerational trauma and immigrant-related adversities. The most cited community-level ACEs were housing instability and community violence. Immigrant related adversities included experiences of systemic racism with loss of resources, political instability limiting structural resources, and language-limited accessibility. These were exacerbated by the loss of family supports due to immigration related family-child separation including deportations and staggered parent-child migration. Having experienced intergenerational trauma and systemic oppression, mothers discussed their strategies for building family unity, instilling resilience in their children, and improving socioeconomic opportunities for their family.
Latina mothers shared the impacts of immigrant-related experiences on systemic inequities in the United States which are currently missing from the ACEs framework. Immigrant specific adverse events include language-limited accessibility, or family-child separations, and policies impacting structural resources for immigrant families. Mothers highlighted their capacity to build resilience in their children and buffer impacts of systemic racism. Community-tailored interventions can build on this foundation to reduce health disparities and promote health equity in this population.
不良的童年经历(ACEs)是衡量童年期毒性应激的一种方法,它与许多成年人的健康结果呈剂量依赖性关系。虽然 ACEs 已经在不同人群中得到验证,用于衡量忽视、虐待和家庭功能障碍,但它们并不能专门评估与种族主义/仇外心理和移民相关的创伤。在美国,54%的拉丁裔青年是移民或移民子女,这是一个潜在的未被测量的创伤群体。本研究超越 ACEs,通过他们母亲的视角,确定拉丁裔青年在农业社区中健康发展的不利和保护因素。
20 位参与 A Crecer:萨利纳斯青少年健康研究(一项对 599 名青少年进行的前瞻性队列研究)的青少年参与者的母亲用西班牙语完成了半结构化访谈。访谈重点是母亲对社区资源、育儿策略、育儿支持系统的看法,以及她们对孩子未来的期望。四位编码员完成了从已发表的 ACEs 框架(原始 ACEs、社区 ACEs)和数据中出现的移民特定不良事件中提取主题编码的迭代回合。
本研究中的母亲报告了社区层面 ACEs 中所包含的不良经历,但也报告了与代际创伤和移民相关逆境相关的独特经历。最常被提及的社区层面 ACEs 是住房不稳定和社区暴力。与移民相关的逆境包括因资源流失而遭受的系统性种族主义、政治不稳定限制结构性资源,以及语言限制的可及性。由于移民相关的家庭-儿童分离,包括驱逐和父母子女移民的交错,家庭支持的丧失使这些情况更加恶化。由于经历了代际创伤和系统性压迫,母亲们讨论了她们建立家庭团结、培养孩子韧性以及改善家庭社会经济机会的策略。
拉丁裔母亲分享了美国移民相关经历对系统性不平等的影响,而这在 ACEs 框架中是缺失的。移民特定的不良事件包括语言限制的可及性或家庭-儿童分离,以及影响移民家庭结构性资源的政策。母亲们强调了她们培养孩子韧性和缓冲系统性种族主义影响的能力。以社区为基础的干预措施可以在此基础上减少这一人群的健康差距,促进健康公平。