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

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2022

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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.

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