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Childhood Trauma and its Lifelong Health Effects More Prevalent Among Minorities
Posted: September 26, 2018
When researchers first discovered a link in the late 1990s between childhood adversity and chronic health problems later in life, the real revelation was how common those experiences were across all socioeconomic groups. But the first major study to focus on adverse childhood experiences (ACEs) was limited to a single healthcare system in San Diego. A study published recently in JAMA Pediatrics — the largest nationally representative study to date on ACEs — confirms that these experiences are universal, yet highlights some disparities among socioeconomic groups. People with low-income and educational attainment, people of color and people who identified as gay, lesbian or bisexual had significantly higher chance of having experienced adversity in childhood.
The study finds three out of five adults across the U.S. had at least one adverse experience in their childhood, such as divorce, a parent's death, physical or emotional abuse, or a family member's incarceration or substance abuse problem. A quarter of adults have at least three such experiences in childhood, which – according to other research — increases their risk for most common chronic diseases, from heart disease and cancer to depression and substance abuse.
"This is the first study of this kind that allows us to talk about adverse childhood experience as a public health problem in the same way we talk about obesity or hypertension or any other highly prevalent population risk factor," says Adam Schickedanz, an assistant professor of pediatrics at the David Geffen School of Medicine at UCLA, who was not involved in the research. "Up until now, we haven't really had a study that takes a national look."
Those identifying as black or Latino and those with less than a high school education or an annual income below $15,000 were more likely to have more ACEs. But a relatively new finding was that multiracial and gay, lesbian and bisexual individuals carried the greatest burden. Multiracial participants reported roughly 2.5 ACEs, and bisexual adults reported 3.1, both the highest scores reported. Women, younger adults, unemployed people and those unable to work also tended to have higher scores.
But Schickedanz cautions that, while the disparities are real, it's important to recognize how common these experiences are among all people, including white and middle class families. "This [study] shows that ACEs affect people from all walks of life everywhere," he says.
This new study suggests a need to target prevention resources where they can help most, says Jack Shonkoff, a professor of child health and development at the Harvard T.H. Chan School of Public Health. This also requires identifying what makes some people more susceptible than others to the effects of adversity.
"Nobody is immune to adverse experiences in childhood but for some population groups, they're a larger burden of childhood adversity than others," he says. "We need to focus on targeting limited resources to the people at greatest risk and making sure those resources go into programs that reduce or mitigate adversity."
Doing that will require developing tools to screen for people's sensitivity to adversity, he says. He also notes that ACEs alone don't account for health disparities. Genetics play a key role in health outcomes as well, he explains.
"Environmental risk factors are only part of the story. You can't separate genetics from environment," Shonkoff says.
To address the consequences of childhood adversity, it will be important to develop programs that help children learn healthy coping mechanisms and strengthen families and communities overall, says Andrew Garner, a clinical professor of pediatrics at Case Western Reserve University School of Medicine in Cleveland.
Read more on NPR.org.