Adverse Childhood Experiences Among Hispanic Children in Immigrant Families Versus US-Native Families

Caballero, Tania Maria; Johnson, Sara B.; Buchanan, Cara; DeCamp, Lisa Ross

doi:10.1542/peds.2017-0297

Cited by 83 publications

(47 citation statements)

References 44 publications

(26 reference statements)

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“…Also of note was that Asian children in our clinic sample had the lowest burden of ACE. This compares well with Caballero et al ’s study using The National Survey of Children’s Health from the USA, which also found children in immigrant families to have significantly lower odds of ACE exposure despite higher prevalence of poverty 31. This information is important for planning effective service delivery, including adequate access and resources for children at risk of ACE.…”

Section: Discussionsupporting

confidence: 83%

Burden of adverse childhood experiences in children attending paediatric clinics in South Western Sydney, Australia: a retrospective audit

Wickramasinghe

Raman

Garg

et al. 2019

bmjpo

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ObjectivesAdverse childhood experiences (ACE) are associated with poor short, medium and long-term health outcomes. South Western Sydney (SWS) has a large culturally diverse population, including many disadvantaged population groups. Our aims were to determine the burden of ACE in children attending community paediatric (CP) clinics using a purposefully developed ACE checklist, and explore any association with developmental health of children.MethodsWe trialled the ACE checklist in all CP clinics including child development (CD) and vulnerable child (VC) clinics between February 2017 and August 2017. Data were collated from completed ACE checklists and relevant clinical information from CP clinics. Statistical analysis was performed using SPSS and MedCalc software.ResultsOf 279 children seen in CP clinics with checklists completed for the period, 167 (60%) attended CD clinics and 112 (40%) attended VC clinics. Seventy-eight (28%) had ACE ≥4 and 178 (64%) had ACE ≥1. Of those attending CD clinics, 8 (5%) had ACE ≥4 compared with 70 (63%) attending VC clinics (p<0.001). Of all age groups, children ≥10 years of age had the highest proportion of children with ACE ≥4 (65%); significant association between age group and ACE ≥4 (p<0.001). There was a significant association between cultural background and ACE ≥4 (p<0.001); indigenous children had the highest proportion of ACE ≥4 (n=21; 64%), followed by Anglo-Australian children (55%). On logistic regression analysis, only attending VC clinics was significantly associated with ACE ≥4. There was no significant association between ACE ≥4 and developmental health.ConclusionAmong children attending CP clinics in SWS, more than a quarter had a significant burden of ACE; those attending specialised clinics for vulnerable children, those from particular ethnic groups and from older age groups, had the highest burden of ACE. Our findings support the need for specialised pathways for paediatric assessment for vulnerable, at-risk children.

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Section: Discussionsupporting

confidence: 83%

Burden of adverse childhood experiences in children attending paediatric clinics in South Western Sydney, Australia: a retrospective audit

Wickramasinghe

Raman

Garg

et al. 2019

bmjpo

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“…The nding may re ect diversity of the Latinx caregivers in our study, where 64% are foreign-born, of whom 50% report immigration from Mexico and 45% from Central America. Several studies point to lower ACEs reported among foreign-born Latinx families compared with U.S.-born (27,28). There are also results that indicate that ACE assessments with Latinx families insu ciently capture Latinx experiences (27).…”

Section: Discussionmentioning

confidence: 99%

“…Several studies point to lower ACEs reported among foreign-born Latinx families compared with U.S.-born (27,28). There are also results that indicate that ACE assessments with Latinx families insu ciently capture Latinx experiences (27).…”

Section: Discussionmentioning

confidence: 99%

A Study of Community and Health Clinic Approaches to Addressing Toxic Stress and Promoting Protective Factors among Families with Infants

McCrae

Robinson²,

Spain

et al. 2020

Preprint

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BackgroundHealth care administrators must promote effective partnerships with community agencies to address social determinants of health, including reducing exposure to chronic stress in early childhood. Important targets for mitigating “toxic” levels of young child exposures are through reducing parents’ experiences of chronic stress as well as protecting children from direct experiences of harm such as physical or sexual abuse. Conducting screening to identify when parents and children are exposed to early life adversity is a first step; bringing in or referring out families to needed support services is an essential component. This paper describes a multi-modal investigation of health care systems innovations to engage and support parents to prevent and mitigate children’s toxic stress exposures through pediatric primary care and community services partnerships.MethodsKey study features include: 1) multi-component, multi-site study in five U.S. communities of pediatric health care clinics and the families they serve, 2) a developmental evaluation approach that describes how systems innovations are experienced over time at three levels (community systems, pediatric providers, and families), and 3) rapid cycle feedback in partnership with communities, clinics and families to co-interpret data and findings. The methodology includes: 1) focus groups and interviews with community stakeholders, clinic staff, and families, 2) electronic health record and Medicaid services data extracted to assess health care quality, and 3) clinic-recruitment of 908 parents of newborns in a longitudinal survey.ResultsThe sample is briefly characterized based on responses to the enrollment phase of the parent survey.ConclusionsWe discuss the study design elements’ contribution to generate evidence needed by innovators, communities, and clinics to modify and sustain investments in these innovations.

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“…For example, children of foreign-born parents report experiencing fewer types of early life adversity relative to children of US-born parents in the National Survey of Children's Health. 21,24 In addition, as reported in the 2011-2014 Behavioral Risk Factor Surveillance System, childhood adversities are disproportionately high among individuals identifying as a sexual minority. 9 Despite these reports of disparities in early life adversity exposure, there has been limited research to understand the variation in the associations between early life adversity and CVD risk across vulnerable populations, and even fewer prevention or treatment studies focused on these concerns.…”

Section: Disparities In Early Life Adversity and Cvd Riskmentioning

confidence: 99%

Social Determinants of Cardiovascular Health: Early Life Adversity as a Contributor to Disparities in Cardiovascular Diseases

Suglia

Campo

Brown

et al. 2020

The Journal of Pediatrics

Self Cite

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ocial determinants of health (SDoH), factors related to the conditions in which people are born, live, work, play, age, and the systems that shape the conditions of daily life, have emerged as key drivers of health and health disparities. 1,2 A strong body of research supports that SDoH are associated with cardiovascular risk factors and outcomes, independently or in conjunction with more traditionally recognized risk factors. As a result, efforts to improve cardiovascular health are predicated on improved understanding of the impact of SDoH on cardiovascular disease (CVD) over the life course. Early life adversity encompasses a variety of SDoH and has been recognized as a contributor to poor cardiometabolic health. 3,4 Early life adversity and adverse childhood experiences are terms often used interchangeably. Early life adversity includes external stressors and experiences of child maltreatment, household dysfunction, 5 bullying, exposure to crime, discrimination, bias, and victimization. 6-8 These are highly prevalent (46% of children, ages 0-17 and 61% of adults are estimated to have experienced at least 1 early life adversity 9) and disproportionately affect racial/ethnic minorities and families of lower socioeconomic status (SES). 9 Early life adversity has been linked to an elevated risk of CVD outcomes in adults, including myocardial infarction, stroke, ischemic heart disease, and coronary heart disease, as well as type 2 diabetes mellitus. 10-13 The 2018 American Heart Association Scientific Statement on Childhood and Adolescent Adversity and Cardiometabolic Outcomes highlighted 3 overall mechanisms of how early life adversity may impact cardiometabolic health, including behavioral, biological, and mental health pathways. 14 These mechanisms have also been implicated in stress research and influence interrelated physiological systems (eg, neural, autonomic, neuroendocrine, immune responses) through different pathways (ie, direct biological pathways with feedback loops, gene-From the

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Adverse Childhood Experiences Among Hispanic Children in Immigrant Families Versus US-Native Families

Cited by 83 publications

References 44 publications

Burden of adverse childhood experiences in children attending paediatric clinics in South Western Sydney, Australia: a retrospective audit

Burden of adverse childhood experiences in children attending paediatric clinics in South Western Sydney, Australia: a retrospective audit

A Study of Community and Health Clinic Approaches to Addressing Toxic Stress and Promoting Protective Factors among Families with Infants

Social Determinants of Cardiovascular Health: Early Life Adversity as a Contributor to Disparities in Cardiovascular Diseases

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