Do Adverse Childhood Experiences Hurt Blacks Worse than Whites?: Race, Family Environments, and Health.

This study is the first to examine racially heterogeneous associations between adverse childhood experiences (ACEs) that occurred in the family environment and adult physical health. Our study is also unique in that we simultaneously explored associations between adult health and the total count of different ACEs as well as between adult health and specific ACEs (physical, verbal, and sexual abuse, parental domestic violence and divorce, and living with someone who was depressed, abused alcohol, abused drugs, or was incarcerated). Using data from 45,892 U.S. non-Hispanic white and non-Hispanic black adults aged 18-64 from the 2009-2012 Behavioral Risk Factor Surveillance System, we found significant differences between whites and blacks in associations between adverse childhood family experiences and adult self-rated health and a prevalent chronic disease - diabetes. First, the negative graded association between the breadth of exposure to adverse childhood experiences (i.e., the cumulative number of different ACEs) and adult self-rated health is stronger for whites than for blacks. Second, while the probability of being diagnosed with diabetes increases with each cumulative ACE among whites, blacks who experienced a very high degree of ACEs during childhood (5 or more) actually have a much lower probability of a diabetes diagnosis than blacks who experienced no ACEs, even when accounting for access to and use of health care services. Third, specific ACEs demonstrate different associations with self-rated health and diabetes for blacks vs. whites. The positive association between parental divorce and diabetes is much stronger for whites than for blacks, and while parental incarceration is associated with worse self-rated health for whites, it is associated with better self-rated health for blacks. Overall, the results of this study highlight the differential salience of various adverse childhood conditions on adult health between whites and blacks, suggesting that adverse childhood experiences have a greater negative impact on health for whites than they do for blacks. Our paper concludes with a discussion of the implications of these findings for research on life course determinants of health. [ABSTRACT FROM AUTHOR]