Adverse childhood experiences in a low-income black cohort: The importance of context

Prev Med. 2021 Jul;148:106557. doi: 10.1016/j.ypmed.2021.106557. Epub 2021 Apr 18.


Adverse Childhood Experiences (ACEs) have been definitively linked with cross-domain life course well-being. While scales measuring the ten "Conventional" ACEs (ACEs-C; intrafamilial experiences of abuse, neglect, and household dysfunction) are parsimonious, use of such scales alone may fail to capture crucial information about adversity, particularly in youth growing up in underresourced areas. Patterns and disparities in Conventional and Expanded ACEs (ACEs-E; experiences more common in impoverished and densely populated areas) were examined in the large, primarily Black Chicago Longitudinal Study cohort. This cohort has been followed from the 1980s to the present. Participants in the present study, comprising over 70% of the original sample, responded to a follow-up survey between 2012 and 2017. ACE information was collected both prospectively and retrospectively. Overall ACE prevalence and differences in ACEs by sex and risk were explored using logistic regression with adjusted and unadjusted odds ratios, and chi-squared tests. Higher sociodemographic risk in early childhood was associated with higher rates of ACEs-C through adolescence. Males endorsed higher rates of ACEs-E, particularly relating to violent crime. Nearly 1/5 of participants reported only ACEs-E, which are often not measured when assessing ACEs. Findings underscore enduring effects of early childhood risk factors on ACE exposure, as well as contributions of community characteristics to childhood adversity. Given strong associations between ACEs, environment, and well-being, enhancing inclusivity in our understanding of childhood adversity is a public health priority.

Keywords: Adverse childhood experiences; Black youth; Community health; Early risk; Urban health; Violence.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adverse Childhood Experiences*
  • Black or African American
  • Chicago / epidemiology
  • Child
  • Child, Preschool
  • Humans
  • Longitudinal Studies
  • Male
  • Retrospective Studies