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Adverse childhood experiences (ACEs) are social determinants of health that increase morbidity and mortality and are prevalent among juvenile justice-involved (JJI) youth. ACEs drive health-risk behaviors (e.g., substance use) that reflect maladaptive coping, increase arrest risk, and overlap with posttraumatic risk-seeking theoretically and reckless/self-destructive behaviors diagnostically. However, little is known, especially among girls, about cumulative developmental adversity burden distress (i.e., total cumulative/lifespan stressor reactivity, grief-specific and adversity-related symptoms, and adversity-driven maladaptive coping strategies by age 18) and associated health risk impacts. Therefore, we assessed (a) developmental adversity burden indicators capturing expanded ACEs (E-ACEs; reflecting cumulative losses and traumatic events), cumulative distress, and risk characteristics; (b) potential racial/ethnic differences in developmental adversity burden; and (c) predictors of maladaptive coping among 223 JJI girls. Participants averaged 15 E-ACEs, endorsing 61.0% of stressor reactivity reactions, 58.4% of cumulative grief-specific symptoms, 55.7% (avoidance) to 73.2% (arousal) of adversity-related symptoms, and 45.0% of adversity-driven maladaptive coping strategies. White JJI girls endorsed significantly higher stressor reactivity and maladaptive coping than Latina girls (e.g., 38.8% vs. 14.6% suicide attempts), ds = 0.56-0.71. Adaptive LASSO analyses of maladaptive coping highlighted primary contributions from stressor reactivity, arousal alterations (excluding reckless/self-destructive behaviors), and cognition/mood alterations but not E-ACEs, grief, avoidance, or intrusions. Participants reported high levels of all cumulative developmental adversity burden indicators (e.g., 81.6% reported reckless/self-destructive behaviors). Results support cumulative, adversity-informed, universal precautions and assessments. Further, emotion regulation interventions targeting stressor reactivity, cognition/mood alterations, and/or arousal alterations may be useful for JJI youth with maladaptive coping., (© 2023 The Authors. Journal of Traumatic Stress published by Wiley Periodicals LLC on behalf of International Society for Traumatic Stress Studies.)

There is inconsistent evidence as to whether gentrification, the increase of affluent residents into low-income neighborhoods, is detrimental to health. To date, there is no systematic evidence on how gentrification may matter for a range of birth outcomes across cities with varying characteristics. We utilize California's Birth Cohort File (2009-2012), Decennial Census data, and the American Community Survey (2008-2012) to investigate the relationship of gentrification to: preterm birth, low birthweight, and small-for-gestational-age across California. We find that socioeconomic gentrification is uniformly associated with better birth outcomes. Notably, however, we find that only places specifically experiencing increases in non-White gentrification had this positive impact. These associations vary somewhat by maternal characteristics and by type of gentrification measure utilized; discrepancies between alternative measurement strategies are explored. This study provides evidence that socioeconomic gentrification is positively related to birth outcomes and the race-ethnic character of gentrification matters, emphasizing the continued need to examine how gentrification may impact a range of health and social outcomes.

Introduction: In the United States, each state sets its own standards for its death investigation system. These may require independent medical examiners and coroners or allow for the sheriff to assume the role of coroner. Motivated by the well-established fact that counts of officer-involved homicides in official data sets grossly undercount the number of these incidents, we examine the possibility that different death investigation systems may lead to different death classification outcomes., Methods: To examine the potential differences in officer-involved homicide underreporting by presence of sheriff-coroner and violent death type (gunshot, intentional use of force, pursuit, or other vehicle accident), we compare ratios of incidents from both the Federal Bureau of Investigation's Supplementary Homicide Reports and the restricted Multiple-Cause of Death files from the National Vital Statistics System to the Fatal Encounters data across coroner contexts in California between 2000 and 2018; we quantify differences descriptively and examine bivariate tests of means., Results: We find significantly greater underreporting of officer-involved deaths in sheriff-coroner counties in both official data sets for all incidents compared with non-sheriff-coroner counties, independently of the period considered. These underreporting differences in the National Vital Statistics System are robust to restricting to gunshot and intentional use of force deaths, the type of incident expected to be less prone to misclassification in that data set., Conclusions: Officer-involved death underreporting in sheriff-coroner counties necessitates further scrutiny. Disparities in officer-involved death reporting suggest political pressure may play a role in classifying deaths., Competing Interests: The authors, reviewers, editors, and publication staff do not report any relevant conflicts of interest., (© The Author(s) 2022.)

Introduction: The most widely used data set for studying police homicides-the Supplementary Homicide Reports (SHR) kept by the Federal Bureau of Investigation-is collected from a voluntary sample., Materials and Methods: Using a journalist-curated database of police-related deaths, we find the SHR police homicide data to be substantially incomplete. This is due to both non-reporting and substantial under-reporting by agencies. Further, our inquiry discloses a pattern of error in identifying "victims" and "offenders" in the data, and finds that investigating agencies are often incorrectly listed as the responsible agency, which seriously jeopardizes police department-level analyses. Finally, there is evidence of sample bias such that the SHR data system is not representative of all police departments, nor is it representative of large police departments., Conclusions: We conclude that the SHR data is of dubious value for assessing correlates of police homicides in the United States, as all analyses using it will reflect these widespread biases and significant undercounts. Analysis of SHR data for these purposes should cease.

Gang violence remains an ongoing crisis in many communities in the United States. This paper assesses the potential association of gang-occupied neighborhoods with birth outcomes. Adverse birth outcomes serve as a "barometer" of population health, denoting both poor conditions for human development and portending future public health concerns. We draw upon (1) Los Angeles County Vital Statistics Birth Records (2008-2012), (2) GIS information on gang territory boundaries, (3) LA city geo-coded crime data, and (4) the 2010 U.S. Census and 2006-2010 American Community Survey. We find an association between gang-occupied neighborhoods and adverse birth outcomes; however, this association is largely explained by other neighborhood socio-demographic characteristics, crime notwithstanding. We also find that gangland neighborhoods tend to exacerbate the effects of crime for all birth outcomes, but only significantly so for small for gestational age births. Lastly, gang co-residence, crime, and other neighborhood demographics explain a substantial portion of socioeconomic and racial/ethnic disparities in adverse birth outcomes. Gangland neighborhoods appear to be a novel contributor to both population health and health disparities. Future studies should address these relationships in a broad range of metropolitan settings, paying careful attention to causal linkages and moderating effects of gangs and crime.

Objectives: Prior studies of the health effects of recessions have shown mixed results. Ecological studies often report a positive relationship between economic downturns and population health while individual-level studies often show that conditions related to recessions are deleterious. Our study examines the spatially and temporally heterogenous effects of the Great Recession (TGR) on adverse birth outcomes, a contemporaneous measure of population health that is highly responsive to changing social conditions., Methods: We use restricted birth cohort data from California (2004-2012) merged with both county- and tract-level socio-demographic data, to explore birth selectivity and temporal and unemployment effects during TGR on adverse birth outcomes., Results: We find that gestational exposure - more specifically, second trimester exposure - during or adjacent to the months of TGR was generally deleterious for birth outcomes, more so, in some cases, for mothers with lower levels of education, and that increases in county-level unemployment were generally deleterious for birth outcomes., Conclusions: Although recessionary effects on population health are problematic and may have far-reaching effects, it appears that these effects may be largely universal, even given potential selective fertility favoring advantaged groups., (© 2019 The Authors.)

Despite profound adversity exposure (loss, trauma) among delinquents, with adversity linked to early-onset persistent delinquency [EOPD], externalizing syndromes (Conduct Disorder) continue to overshadow impairing internalizing syndromes. Three understudied factors potentially contribute to both syndromes among delinquents: bereavement-related distress [BRD] from death-exposures; psychopathy-spectrum traits associated with system-involvement; and emotional abuse, implicated in lifespan morbidities. Therefore, we characterized loss/BRD among 107 EOPD adolescent girls and boys, comparing: 1) psychopathology and maltreatment (emotional, physical and sexual abuse); and 2) adversity-related (BRD, Post-traumatic Stress Disorder [PTSD], maltreatment) and psychopathy-spectrum predictors of internalizing and externalizing syndromes. Death exposure was common, resulting in developmental disruptions (school difficulties: 49.4%) and clinically significant BRD (33.8%), with girls evidencing greater BRD severity. BRD and psychopathy-traits, not PTSD, positively predicted all youths' internalizing, and boys' externalizing, syndromes. More frequent physical abuse increased both syndromes among boys. Emotional abuse alone predicted girls' externalizing syndromes, highlighting the contribution of this overlooked maltreatment-type., Competing Interests: Conflict of Interest Statement: On behalf of all authors, the corresponding author states that there is no conflict of interest.

Objectives: No studies have focused on socioeconomic disparities in obesity within and between cohorts. Our objectives were to examine income gradients in obesity between birth-cohorts (inter-cohort variations) and within each birth-cohort (intra-cohort variations) by gender and race/ethnicity., Methods: Our sample includes 56,820 white and black adults from pooled, cross-sectional National Health and Nutrition Examination Surveys (1971-2012). We fit a series of logistic hierarchical Age-Period-Cohort models to control for the effects of age and period, simultaneously. Predicted probabilities of obesity by poverty-to-income ratio were estimated and graphed for 5-year cohort groups from 1901-1990. We also stratified this relationship for four gender and racial/ethnic subgroups., Results: Obesity disparities due to income were weaker for post-World War I and II generations, specifically the mid-1920s and the mid-1940s to 1950s cohorts, than for other cohorts. In contrast, we found greater income gradients in obesity among cohorts from the 1930s to mid-1940s and mid-1960s to 1970s. Moreover, obesity disparities due to income across cohorts vary markedly by gender and race/ethnicity. White women with higher income consistently exhibited a lower likelihood of obesity than those with lower income since early 1900s cohorts; whereas, black men with higher income exhibited higher risks of obesity than those with lower income in most cohorts., Conclusions: Our findings suggest that strategies that address race and/or gender inequalities in obesity should be cognizant of significant historical factors that may be unique to cohorts. Period-based approaches that ignore life-course experiences captured in significant cohort-based experiences may limit the utility of policies and interventions., (© 2017 Wiley Periodicals, Inc.)

Aim: Psychotic-spectrum symptoms are linked to trauma, substance/alcohol use (SAU), criminality/violence and poor functional outcomes, supporting the need for early detection in vulnerable populations. To better understand high-risk girls' mental health, we assessed: (1) psychotic-spectrum symptoms; (2) cumulative trauma, adversity and loss exposures (C-TALE) and adversity-indicators (symptoms, maladaptive coping, stressor-reactivity); and SAU risk-factors; and (3) relationships among psychotic-spectrum symptoms, adversity-indicators and SAU risk-factors., Methods: We administered the Structured Clinical Interviews for Psychotic Spectrum, and Trauma and Loss Spectrum to 158 adolescent delinquent girls., Results: Girls' psychotic-spectrum profiles were similar to previously reported adult psychotic patients and characterized by typical symptoms (hallucinations/delusions, reported largely SAU-independent), interpersonal sensitivity, schizoid traits and paranoia (over-interpretation, anger over-reactivity, hypervigilance). Auditory/visual hallucinations (55.7%), delusions (92.4%), ideas of reference (96.8%) and adversity (90.0% ≥10/24 C-TALE-types) were common. Mean loss (4) and trauma (8) onset-age occurred before SAU-onset (12). Significant positive correlations were found among psychotic-spectrum symptoms, stressor-reactivity, C-TALE, adversity-indicators; and number of SAU-types; and a negative correlation occurred between psychotic-spectrum symptoms and earlier alcohol use onset. After controlling for number of SAU-types, stressor-reactivity and adversity-related numbing individually had the largest associations with total psychotic-spectrum symptoms (b = 2.6-4.3). Girls averaged more than 4 maladaptive coping strategies (e.g., 24.8% attempted suicide) in response to adversity, amplifying potential health-disparities. No racial/ethnic differences emerged on psychotic-spectrum symptoms., Conclusions: This symptom constellation during adolescence likely interferes with social and academic functioning. Whether representing a prodromal phase, trauma-response or cross-diagnostic psychopathology, accurate early detection and appropriate treatment of psychotic-spectrum symptoms are warranted to improve functional outcomes in vulnerable populations., (© 2017 John Wiley & Sons Australia, Ltd.)

Despite growing recognition that cumulative adversity (total stressor exposure, including complex trauma), increases the risk for psychopathology and impacts development, assessment strategies lag behind: Adversity-related mental health needs (symptoms, functional impairment, maladaptive coping) are typically assessed in response to only one qualifying Criterion-A traumatic event. This is especially problematic for youth at-risk for health and academic disparities who experience cumulative adversity, including non-qualifying events (separation from caregivers) which may produce more impairing symptomatology. Data from 118 delinquent girls demonstrate: (1) an average of 14 adverse Criterion-A and non-Criterion event exposures; (2) serious maladaptive coping strategies (self-injury) directly in response to cumulative adversity; (3) more cumulative adversity-related than worst-event related symptomatology and functional impairment; and (4) comparable symptomatology, but greater functional impairment, in response to non-Criterion events. These data support the evaluation of mental health needs in response to cumulative adversity for optimal identification and tailoring of services in high-risk populations to reduce disparities., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Background: Although evidence has shown that U.S. late-life disability has been declining, studies have also suggested that there has been an increase in chronic diseases between 1984 and 2007., Objectives: To further illuminate these potentially contradictory trends, we explicate how the contribution of chronic conditions changes across four common types of disability (ADL, IADL, mobility disability, and functional limitations) by age (A), period (P), and birth cohorts (C) among adults aged 20 and above., Methods: Our data came from seven cross-sectional waves of the National Health and Nutrition Examination Survey (NHANES). We utilize a cross-classified random effect model (CCREM) to simultaneously estimate age, period, and cohort trends for each disability. Each chronic condition was sequentially then simultaneously added to our base models (sociodemographics only). Reductions in predicted probability from the base model were then calculated for each chronic condition by each temporal dimension (A/P/C) to assess the contribution of each chronic condition., Results: There was increasing age-based contribution of chronic conditions to all disabilities. The period-based contribution remained quite stagnant across years while cohort-based contributions showed a continual decline for recent cohorts. Arthritis showed the greatest contribution to disability of all types which was followed by obesity. Cancer was the least important contributor to disabilities., Conclusion: Although chronic conditions are becoming less disabling across recent cohorts, other competing risk factors might suggest prevailing causes of disability., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Objectives: The rise in nonmarital childbearing has raised concerns about coparenting among unmarried parents with increasingly complicated relationship trajectories. We address this issue by examining associations between mothers' partnership transitions and coparenting and the moderating role of maternal race/ethnicity and child gender., Methods: Data from the Fragile Families Study and ordinary least squares regression techniques are used to examine whether mothers' partnership transitions are related to coparenting. Lagged and fixed effects models are employed to test the robustness of the findings to selection., Results: Coresidential and nonresidential, dating transitions are negatively associated with coparenting, but the association is stronger for coresidential transitions than for dating transitions. Coresidential transitions are stronger predictors of coparenting for White parents than for Black parents and for parents of sons than for parents of daughters., Conclusions: Policies aimed at strengthening families should emphasize relationship stability, regardless of the type of union, to promote high quality coparenting among at-risk populations.

Objectives: This study delineates activities of daily living (ADL) and instrumental activities of daily living (IADL) black-white disparity trends by age, period, and cohort (APC) and explores sociodemographic contributors of cohort-based disparity trends., Method: We utilized multiple cross-sectional waves of National Health Interview Survey data (1982-2009) to describe APC trends of ADL and IADL disparities using a cross-classified random effect model. Further, we decomposed the cohort-based disparity trends using Fairlie's decomposition method for nonlinear outcomes., Results: The crossover ADL and IADL disparities (whites > blacks) occurring at age 75 increased with age and reached a plateau at age of 80, whereas period-based ADL and IADL disparities remained constant for the past 3 decades. The cohort disparity trends for both disabilities showed a decline with each successive cohort except for ADL disparity among women., Discussion: We examined the role of aging on racial disparity in disability and found support for the racial crossover effect. Further, the racial disparity in disability will disappear should the observed pattern of declining cohort-based ADL and IADL disparities persist. Although education, income, and marital status are important sociodemographic contributors to cohort disparity trends, future studies should investigate individual behavioral health determinants and cohort-specific characteristics that explain the cohort-based racial difference in ADL and IADL disabilities., (© The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

This paper uses data from the U.S. National Health Interview Surveys (N = 1,513,097) to describe and explain temporal patterns in black-white health disparities with models that simultaneously consider the unique effects of age, period, and cohort. First, we employ cross-classified random effects age-period-cohort (APC) models to document black-white disparities in self-rated health across temporal dimensions. Second, we use decomposition techniques to shed light on the extent to which socio-economic shifts in cohort composition explain the age and period adjusted racial health disparities across successive birth cohorts. Third, we examine the extent to which exogenous conditions at the time of birth help explain the racial disparities across successive cohorts. Results show that black-white disparities are wider among the pre-1935 cohorts for women, falling thereafter; disparities for men exhibit a similar pattern but exhibit narrowing among cohorts born earlier in the century. Differences in socioeconomic composition consistently contribute to racial health disparities across cohorts; notably, marital status differences by race emerge as an increasingly important explanatory factor in more recent cohorts for women whereas employment differences by race emerge as increasingly salient in more recent cohorts for men. Finally, our cohort characteristics models suggest that cohort economic conditions at the time of birth (percent large family, farm or Southern birth) help explain racial disparities in health for both men and women., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Objectives: We elucidated how US late-life disability prevalence has changed over the past 3 decades., Methods: We examined activities of daily living (ADL) and instrumental activities of daily living (IADL) disability trends by using age-period-cohort (APC) models among older adults aged 70 years or older who responded to the National Health Interview Survey between 1982 and 2009. We fitted logistic regressions for ADL and IADL disabilities and for each of the 3 APC trends with 2 models: unadjusted and fully adjusted for age, period, cohort, and sociodemographic variables., Results: The unadjusted and adjusted period trends showed a substantial decline in IADL disability, and ADL disability remained stable across time. Unadjusted cohort trends for both outcomes also showed continual declines across successive cohorts; however, increasing cohort trends were evident in the adjusted models., Conclusions: More recent cohorts of US older adults are becoming more disabled, net of aging and period effects. The net upward cohort trends in ADL and IADL disabilities remain unexplained. Further studies should explore cohort-specific determinants contributing to the increase of cohort-based disability among US older adults.

This paper uses recent longitudinal data about a cohort of young children born in the United States to mostly unmarried parents to examine the association between increasingly-complex patterns of family instability and physical health in early childhood. The analyses assess whether, and how, the association between family instability and child health varies across a number of family types. We consider several measures of children's health at age five (overweight/obesity, asthma diagnosis and overall health) and examine to what extent the association between family instability and child health varies across outcomes and depends on the number and timing of any familial transitions. We also explore a number of potential mechanisms through which family instability may affect child health. The results suggest that familial instability is related to worse child health, particularly among children born to coresident (married or cohabiting) biological parents and for children who experience high levels of residential instability., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Trends in family formation during the past several decades have increased children's exposure to mothers' partnership instability, defined as an entrance into or exit from a coresidential union or a dating partnership. Instability, in turn, is associated with negative outcomes for children and adolescents. This study uses data from the Fragile Families and Child Wellbeing Study to examine associations between mothers' partnership instability and children's school readiness, differences between coresidential and dating transitions, and the moderating role of child gender. Mothers' partnership transitions are negatively associated with children's verbal ability and positively associated with boys' behavioral problems at age five. In general, coresidential and dating transitions have similar effects on school readiness. The findings have important implications for our understanding of the growing gender gap in educational attainment.

This study explores socio-economic gradients in height (stature-for-age) among a nationally representative sample of 2-6 year old children in the United States. We use NHANES III (1988-1994) Youth data linked with a special Natality Data supplement which contains information from birth certificates among sampled NHANES III Youth who are < 7 years of age. Our results indicate significant socio-economic gradients for both maternal education and family income, net of controls for confounders, including: birth weight, gestational age, family size, and parental heights. These results are in stark contrast to those from other developed countries that seem to indicate diminished or eliminated socio-economic disparities, net of known confounders. In the United States, it appears that socio-economic gradients have an effect on birth outcomes, and continue to have an additional direct and independent effect on height, even in early childhood., (Copyright © 2011 Elsevier B.V. All rights reserved.)

As nonmarital childbearing escalated in the United States over the past half century, fragile families--defined as unmarried couples with children--drew increased interest from researchers and policy makers. Sara McLanahan and Audrey Beck discuss four aspects of parental relationships in these families: the quality of parents' intimate relationship, the stability of that relationship, the quality of the co-parenting relationship among parents who live apart, and nonresident fathers' involvement with their child. At the time of their child's birth, half of the parents in fragile families are living together and another third are living apart but romantically involved. Despite high hopes at birth, five years later only a third of parents are still together, and new partners and new children are common, leading to high levels of instability and complexity in these families. Drawing on findings from the Fragile Families and Child Wellbeing Study, McLanahan and Beck highlight a number of predictors of low relationship quality and stability in these families, including low economic resources, government policies that discourage marriage, gender distrust and acceptance of single motherhood, sex ratios that favor men, children from previous unions, and psychological factors that make it difficult for parents to maintain healthy relationships. No single factor appears to have a dominant effect. The authors next discuss two types of experiments that attempt to establish causal effects on parental relationships: those aimed at altering economic resources and those aimed at improving relationships. What can be done to strengthen parental relationships in fragile families? The authors note that although economic resources are a consistent predictor of stable relationships, researchers and policy makers lack good causal information on whether increasing fathers' employment and earnings will increase relationship quality and union stability. They also note that analysts need to know more about whether relationship quality in fragile families can be improved directly and whether doing so will increase union stability, father involvement, and co-parenting quality.

We use data from the Fragile Families and Child Wellbeing Study (N = 1,975) to examine the association between mothers' partnership changes and parenting behavior during the first five years of their children's lives. We compare coresidential with dating transitions, and recent with more distal transitions. We also examine interactions between transitions and race/ethnicity, maternal education and family structure at birth. Findings indicate that both coresidential and dating transitions were associated with higher levels of maternal stress and harsh parenting; recent transitions had stronger associations than distal transitions. Maternal education significantly moderates these associations, with less educated mothers responding more negatively to instability in terms of maternal stress, and more educated mothers responding more negatively in terms of literacy activities.

More than a century of empirical evidence links marital status to mortality. However, the hazards of dying associated with long-term marital trajectories and contributing risk factors are largely unknown. The authors used 1992-2006 prospective data from a cohort of US adults to investigate the impact of current marital status, marriage timing, divorce and widow transitions, and marital durations on mortality. Multivariate hazard ratios were significantly higher for adults currently divorced and widowed, married at young ages (< or =18 years), who accumulated divorce and widow transitions (among women), and who were divorced for 1-4 years. Results also showed significantly lower risks of mortality for men married after age 25 years compared with on time (ages 19-25 years) and among women experiencing > or =10 years of divorce and > or =5 years of widowhood relative to those without exposure to these statuses. For both sexes, accumulation of marriage duration was the most robust predictor of survival. Results from risk-adjusted models indicated that socioeconomic resources, health behaviors, and health status attenuated the associations in different ways for men and women. The study demonstrates that traditional measures oversimplify the relation between marital status and mortality and that sex differences are related to a nexus of marital experiences and associated health risks.