Adverse Childhood Experiences (ACEs) are an increasing area of interest among researchers, practitioners, and policymakers. As this field of study grows, an equity lens can facilitate a greater understanding of the structural, historic, and systemic contexts that relate to limited ACEs data for American Indians and Alaska Natives (AI/ANs), as well as disparate exposures to ACEs among this population. Three factors are important to consider in support of more equitable outcomes: AI/AN population characteristics, historical trauma and resilience, and tribal sovereignty.
First, characteristics of the AI/AN population require concerted efforts by researchers to include this population in the rapidly developing ACEs field. The population’s size and diversity, age distribution, and percentage of children living in poverty underscore this consideration. In the United States, an estimated 5.6 million people (1.7 percent of the total population) self-identify as AI/AN alone or in combination with one or more other races, and there are currently 573 federally recognized tribes.
Because the AI/AN population represents one of the smaller racial/ethnic groups in the United States, studies often do not include samples adequate for disaggregated AI/AN findings. Consequently, AI/AN data are typically grouped in an “Other” category, or not analyzed at all. Additionally, when AI/AN statistics are reported, they are often thought to represent a monolithic group, an assumption that overlooks the unique cultures, histories, and contexts of the many tribes in the United States. Meaningful inclusion of AI/ANs in future ACEs work will require oversampling, research and analyses focused on states or regions with large AI/AN populations, and direct partnership with tribes. Prior ACEs work in states like South Dakota and Minnesota and with multiple tribes can serve as examples.
The AI/AN population is also relatively young. In fact, in eight states children under age 18 are estimated to make up one-third or more of the AI/AN population. From a public health perspective, this means that a focus on ACEs among AI/ANs could deliver important long-term benefits—especially given that ACEs increase the level of risk for many of the same negative outcomes (e.g., alcohol and substance use, mental health disorders) that Indian Health Service (IHS) data indicate are concerns for AI/ANs nationally and in specific IHS regions.
AI/AN children are more likely to have experienced certain adverse childhood experiences, which can have negative effects throughout their lives.
ACEs have been linked with numerous negative outcomes, including alcoholism, drug abuse, depression, suicide, and poor physical health.
Second, researchers should consider concepts of historical trauma and resilience in their efforts to understand ACEs among AI/AN populations. Child Trends’ brief notes that there is “no single agreed-upon list of experiences that encompass what we refer to as adverse childhood experiences.” To address links between ACEs and AI/AN well-being, it is essential that we understand whether some adversities are uniquely important to AI/AN contexts. For instance, AI/AN scholars have written for decades about the concept of multi-level, intergenerational impacts of historical trauma. Some have even begun to incorporate measures that capture symptoms of historical trauma alongside standard ACEs measures to better understand health outcomes for AI/AN youth.
Read more on ChildTrends.org.