CitationMersky, J. P.; Choi, C.; Plummer Lee, C.; & Janczewski, C. E. (2021). Disparities in adverse childhood experiences by race/ethnicity, gender, and economic status: Intersectional analysis of a nationally representative sample. Child Abuse and Neglect. vol. 117
AbstractBackground: Adverse childhood experiences (ACEs) are disturbingly common and consequential. Priority should be given to identifying populations that bear a disproportionate share of the burden of ACEs, but such disparities have received limited attention to date. Objective: This study analyzes data from the National Longitudinal Study of Adolescent to Adult Health, a nationally representative sample in the U.S., to explore variation in ACEs by race/ethnicity, economic status, and gender. Methods: In addition to using conventional statistical methods to generate unadjusted and adjusted estimates, we conduct an intercategorical intersectional analysis of variation in ACEs using multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA). Results: Descriptively, we find that ACEs are more prevalent overall among the poor than the non-poor, among most racial/ethnic minority groups than non-Hispanic Whites, and among females than males. However, multivariate regression results indicate that gender is not a robust correlate of cumulative adversity and that economic status moderates racial/ethnic differences. MAIHDA models further expose heterogeneity in aggregate ACE scores between intersectional strata representing unique combinations of gender, race/ethnicity, and economic status. Conclusions: The MAIHDA results confirm that conclusions based on unadjusted group differences may be spurious. While most variance in ACE scores is explained by additive main effects, accounting for intersections among social categories generates a more complex portrait of inequality. We compare our work to prior studies and discuss potential explanations for and implications of these findings for research on disparities. © 2021 Elsevier Ltd
Keyword(s)Adverse childhood experiences
NotesExport Date: 4 May 2021 CODEN: CABND Correspondence Address: Mersky, J.P.; Institute for Child and Family Well-Being, 2400 E. Hartford Ave., United States; email: email@example.com References: Andersen, J.P., Blosnich, J., Disparities in adverse childhood experiences among sexual minority and heterosexual adults: Results from a multi-state probability-based sample (2013) PloS One, 8 (1); Axelsson Fisk, S., Mulinari, S., Wemrell, M., Leckie, G., Vicente, R.P., Merlo, J., Chronic obstructive pulmonary disease in Sweden: An intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy (2018) SSM-Population Health, 4, pp. 334-346; Barth, J., Bermetz, L., Heim, E., Trelle, S., Tonia, T., The current prevalence of child sexual abuse worldwide: A systematic review and meta-analysis (2013) International Journal of Public Health, 58 (3), pp. 469-483; Bauer, G.R., Scheim, A.I., Methods for analytic intercategorical intersectionality in quantitative research: Discrimination as a mediator of health inequalities (2019) Social Science & Medicine, 226, pp. 236-245; Bell, A., Holman, D., Jones, K., Using shrinkage in multilevel models to understand intersectionality: A simulation study and a guide for best practice (2019) Methodology, 15 (2), pp. 88-96; Bellis, M.A., Hughes, K., Ford, K., Rodriguez, G.R., Sethi, D., Passmore, J., Life course health consequences and associated annual costs of adverse childhood experiences across Europe and North America: A systematic review and meta-analysis (2019) The Lancet Public Health, 4 (10), pp. e517-e528; Breslau, J., Aguilar-Gaxiola, S., Kendler, K.S., Su, M., Williams, D., Kessler, R.C., Specifying race-ethnic differences in risk for psychiatric disorder in a USA national sample (2006) Psychological Medicine, 36 (1), pp. 57-68; Chetty, R., Hendren, N., Jones, M.R., Porter, S.R., Race and economic opportunity in the United States: An intergenerational perspective (2020) The Quarterly Journal of Economics, 135 (2), pp. 711-783; Crenshaw, K., Mapping the margins: Intersectionality, identity politics, and violence against women of color (1991) Stanford Law Review, 43, pp. 1241-1299; Cronholm, P.F., Forke, C.M., Wade, R., Bair-Merritt, M.H., Davis, M., Harkins-Schwarz, M., Fein, J.A., Adverse childhood experiences: Expanding the concept of adversity (2015) American Journal of Preventive Medicine, 49 (3), pp. 354-361; Crouch, E., Probst, J.C., Radcliff, E., Bennett, K.J., McKinney, S.H., Prevalence of adverse childhood experiences (ACEs) among US children (2019) Child Abuse & Neglect, 92, pp. 209-218; DeNavas-Walt, C., Proctor, B.D., US Census Bureau, current population reports, P60-252, income and poverty in the United States: 2014 (2015), US Government Printing Office Washington, DC; Department of Health Care Services - State of California - Health, Human Services Agency, (2019) Proposition 56 trauma screening; Drake, B., Lee, S.M., Jonson-Reid, M., Race and child maltreatment reporting: Are Blacks overrepresented? (2009) Children and Youth Services Review, 31 (3), pp. 309-316; Dube, S.R., Anda, R.F., Felitti, V.J., Chapman, D.P., Williamson, D.F., Giles, W.H., Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span: Findings from the Adverse Childhood Experiences Study (2001) JAMA, 286 (24), pp. 3089-3096; Duke, N.N., Pettingell, S.L., McMorris, B.J., Borowsky, I.W., Adolescent violence perpetration: Associations with multiple types of adverse childhood experiences (2010) Pediatrics, 125 (4), pp. e778-e786; Else-Quest, N.M., Hyde, J.S., Intersectionality in quantitative psychological research: I. Theoretical and epistemological issues (2016) Psychology of Women Quarterly, 40 (2), pp. 155-170; Evans, C.R., Erickson, N., Intersectionality and depression in adolescence and early adulthood: A MAIHDA analysis of the national longitudinal study of adolescent to adult health, 1995–2008 (2019) Social Science & Medicine, 220, pp. 1-11; Evans, C.R., Leckie, G., Merlo, J., Multilevel versus single-level regression for the analysis of multilevel information: The case of quantitative intersectional analysis (2020) Social Science & Medicine, 245; Evans, C.R., Williams, D.R., Onnela, J.P., Subramanian, S.V., A multil vel approach to modeling health inequalities at the intersection of multiple social identities (2018) Social Science & Medicine, 203, pp. 64-73; Finkelhor, D., Shattuck, A., Turner, H., Hamby, S., A revised inventory of adverse childhood experiences (2015) Child Abuse & Neglect, 48, pp. 13-21; Green, J.G., McLaughlin, K.A., Berglund, P.A., Gruber, M.J., Sampson, N.A., Zaslavsky, A.M., Kessler, R.C., Childhood adversities and adult psychiatric disorders in the national comorbidity survey replication I: Associations with first onset of DSM-IV disorders (2010) Archives of General Psychiatry, 67 (2), pp. 113-123; Halfon, N., Larson, K., Son, J., Lu, M., Bethell, C., Income inequality and the differential effect of adverse childhood experiences in US children (2017) Academic Pediatrics, 17 (7), pp. S70-S78; Harris, K.M., The Add Health Study: Design and accomplishments (2013), pp. 1-22. , Chapel Hill: Carolina Population Center, University of North Carolina at Chapel Hill; Hasin, D.S., Grant, B.F., The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) Waves 1 and 2: Review and summary of findings (2015) Social Psychiatry and Psychiatric Epidemiology, 50 (11), pp. 1609-1640; Hernández-Yumar, A., Wemrell, M., Abasolo Alesson, I., González López-Valcárcel, B., Leckie, G., Merlo, J., Socioeconomic differences in body mass index in Spain: An intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy (2018) PloS One, 13 (12); Hughes, K., Bellis, M.A., Hardcastle, K.A., Sethi, D., Butchart, A., Mikton, C., Dunne, M.P., The effect of multiple adverse childhood experiences on health: A systematic review and meta-analysis (2017) The Lancet Public Health, 2 (8), pp. e356-e366; Hutzell, K.L., Payne, A.A., The relationship between bullying victimization and school avoidance: An examination of direct associations, protective influences, and aggravating factors (2018) Journal of School Violence, 17 (2), pp. 210-226; Kim, H., Drake, B., Child maltreatment risk as a function of poverty and race/ethnicity in the USA (2018) International Journal of Epidemiology, 47 (3), pp. 780-787; Lizotte, D.J., Mahendran, M., Churchill, S.M., Bauer, G.R., Math versus meaning in MAIHDA: A commentary on multilevel statistical models for quantitative intersectionality (2020) Social Science & Medicine, 245; Maguire-Jack, K., Lanier, P., Lombardi, B., Investigating racial differences in clusters of adverse childhood experiences (2020) American Journal of Orthopsychiatry, 90 (1), pp. 106-114; McCall, L., The complexity of intersectionality (2005) Signs: Journal of Women in Culture and Society, 30 (3), pp. 1771-1800; McKernan, S.M., Ratcliffe, C., Steuerle, E., Zhang, S., Disparities in wealth accumulation and loss from the great recession and beyond (2014) American Economic Review, 104 (5), pp. 240-244; Merlo, J., Multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) within an intersectional framework (2018) Social Science & Medicine, 203, pp. 74-80; Merrick, M.T., Ford, D.C., Ports, K.A., Guinn, A.S., Prevalence of adverse childhood experiences from the 2011-2014 behavioral risk factor surveillance system in 23 states (2018) JAMA Pediatrics, 172 (11), pp. 1038-1044; Mersky, J.P., Janczewski, C.E., Topitzes, J., Rethinking the measurement of adversity: Moving toward second-generation research on adverse childhood experiences (2017) Child Maltreatment, 22 (1), pp. 58-68; Mersky, J.P., Janczewski, C.E., Racial and ethnic differences in the prevalence of adverse childhood experiences: Findings from a low-income sample of US women (2018) Child Abuse & Neglect, 76, pp. 480-487; Mersky, J.P., Janczewski, C.E., Nitkowski, J.C., Pathways to poor mental health among low-income women in the U. S.: Exploring the role of adverse childhood and adult experiences (2018) Social Science and Medicine, 206, pp. 14-21; Metzler, M., Merrick, M.T., Klevens, J., Ports, K.A., Ford, D.C., Adverse childhood experiences and life opportunities: Shifting the narrative (2017) Children and Youth Services R view, 72, pp. 141-149; Moody, G., Cannings-John, R., Hood, K., Kemp, A., Robling, M., Establishing the international prevalence of self-reported child maltreatment: A systematic review by maltreatment type and gender (2018) BMC Public Health, 18 (1), pp. 1-15; Putnam-Hornstein, E., Needell, B., King, B., Johnson-Motoyama, M., Racial and ethnic disparities: A population-based examination of risk factors for involvement with child protective services (2013) Child Abuse & Neglect, 37 (1), pp. 33-46; Riolo, S.A., Nguyen, T.A., Greden, J.F., King, C.A., Prevalence of depression by race/ethnicity: Findings from the National Health and Nutrition Examination Survey III (2005) American Journal of Public Health, 95 (6), pp. 998-1000; Schofield, T.J., Donnellan, M.B., Merrick, M.T., Ports, K.A., Klevens, J., Leeb, R., Intergenerational continuity in adverse childhood experiences and rural community environments (2018) American Journal of Public Health, 108 (9), pp. 1148-1152; Sharkey, P., The long reach of violence: A broader perspective on data, theory, and evidence on the prevalence and consequences of exposure to violence (2018) Annual Review of Criminology, 1, pp. 85-102; Slopen, N., Shonkoff, J.P., Albert, M.A., Yoshikawa, H., Jacobs, A., Stoltz, R., Williams, D.R., Racial disparities in child adversity in the US: Interactions with family immigration history and income (2016) American Journal of Preventive Medicine, 50 (1), pp. 47-56; Strompolis, M., Tucker, W., Crouch, E., Radcliff, E., The intersectionality of adverse childhood experiences, race/ethnicity, and income: Implications for policy (2019) Journal of Prevention & Intervention in the Community, 47 (4), pp. 310-324; Walsh, D., McCartney, G., Smith, M., Armour, G., Relationship between childhood socioeconomic position and adverse childhood experiences (ACEs): A systematic review (2019) Journal of Epidemiology and Community Health, 73 (12), pp. 1087-1093; Wemrell, M., Mulinari, S., Merlo, J., An intersectional approach to multilevel analysis of individual heterogeneity (MAIH) and discriminatory accuracy (2017) Social Science and Medicine, 178, pp. 217-219
Reference TypeJournal Article
Journal TitleChild Abuse and Neglect
Author(s)Mersky, J. P.
Plummer Lee, C.
Janczewski, C. E.