Marcus Post Lydia, Topitzes J, Do D Phuong, Cho Young I, Pathak Dorothy R, Nuru-Jeter Amani, Kwarteng Jamila L, Dominguez Tyan Parker, Hamilton Ann S, Hirko Kelly A, Schwartz Ann G, Velie Ellen M
Epidemiology Program, Joseph J. Zilber College of Public Health, University of Wisconsin - Milwaukee, Milwaukee, WI, USA.
Social Work Department, Helen Bader School of Social Welfare, University of Wisconsin - Milwaukee, Milwaukee, WI, USA.
BMC Public Health. 2025 May 2;25(1):1636. doi: 10.1186/s12889-025-22589-4.
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.
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.
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.
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.
社会经济地位不利和种族少数群体遭受不良童年经历（ACEs）的风险较高，但很少有研究评估ACEs中的种族差异在社会经济阶层中是否持续存在。我们研究了童年社会经济特征和种族对ACE负担的影响。
数据来自2011 - 2014年在底特律都会区和洛杉矶县对20 - 49岁美国出生的非西班牙裔黑人（NHB）和白人（NHW）女性进行的基于人群的样本（N = 1381）。在面对面访谈中收集了关于13岁之前的ACEs、13岁之前的童年家庭社会经济地位（chSEP）、6岁时的童年邻里贫困率（cNPR）（基于美国人口普查区）以及协变量的回忆数据。ACEs被参数化为一个指数（即逆境数量，范围0 - 12）以及个体逆境。我们使用加权逻辑回归估计cNPR（≥20%/10 - <20%/<10%）、chSEP指数（低/中/高）、种族（NHB/NHW）、联合cNPR/种族以及联合chSEP/种族与ACEs之间的关联，以计算比值比（OR），并使用加权零膨胀泊松回归计算估计的ACE指数。
童年时期生活在较贫困社区（即cNPR≥20%）或家庭（即chSEP指数低）的参与者报告的ACEs显著多于生活在较富裕社区（即cNPR<10%）或家庭（即chSEP指数高）的参与者。总体而言，NHB与NHW参与者的平均ACE指数较高（分别为3.18和2.25，p<0.05），但生活在较贫困社区或家庭的NHB和NHW参与者的ACE负担同样有所增加（例如，chSEP低时估计的ACE指数分别为3.63[95%CI 1.19 - 4.97]和4.16[95%CI 3.68 - 4.65]）。NHB参与者在所有cNPR和chSEP水平上都经历了显著的歧视，这导致了他们总体ACE风险的增加。
居住在较贫困社区或家庭的美国出生的NHB和NHW女孩的ACE负担同样大幅增加，表明童年贫困是ACE风险的关键决定因素，与种族无关。
