Evaluating immigrant-specific adverse childhood experiences as a social determinant of health among Latino immigrant families

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Conway, C. Andrew
Lew, Amy
Research consistently demonstrates the critical role of Adverse Childhood Experiences (ACEs), traditionally defined as exposure to abuse, neglect, and household risk factors, in shaping overall health and well-being throughout life and even across generations. However, our current conceptualization and measurement of ACEs are based on items initially examined in a primarily white, middle-class, highly educated sample. This strategy may provide a limited understanding of childhood adversity within marginalized groups. This study aimed to examine the relationship between ACEs (both traditionally studied ACEs and immigrant-specific ACEs) and the psychological well-being of Latino immigrant adolescents. The relationship between parental experiences of ACEs, child ACEs, and child psychological well-being was also explored. Data comes from a community sample of 338 Latino immigrant adolescents. These youth completed an 11-item measure of traditional ACEs (ACE-T), a novel 13-item measure of immigrant-specific ACEs (ACE-I), the Strengths and Difficulties Questionnaire, and health risk behavior items as part of the intake process for a positive youth development program. Data on parent ACEs was available for a subsample (n¬ = 112). Structural equation modeling was used to examine the relationship between the ACEs measures and the psychological and health risk outcomes. Immigrant youth, on average, reported more adversities on the ACE-I measure than the ACE-T measure (3.6 vs. 1.6). Both ACE-T and ACE-I scores were positively related to increased emotional issues (standardized coefficients were .24 and .25, respectively). Only ACE-T scores were related to increased conduct problems and peer relationship problems. There was no relationship between adolescents' ACE-T or ACE-I scores with prosocial or health risk behaviors. The parent's ACE-T scores were positively related to the child's ACE-T scores (b = .18). These findings suggest that essential early adverse experiences for immigrants, which have not been considered, impact adolescents' psychological well-being. Broadening our conceptualization and measurement of ACEs among immigrant populations could provide valuable insight into social determinants of health and avenues for intervention for immigrant adolescents and families.