Racial Discrimination, Adverse Childhood Experiences, and Behavior Problems among Racial-Ethnic Minority Youth: A Systematic Review

• In Event: Discrimination, Identity, and the Health of Racially Minoritized Youth

Abstract

Childhood adversities, commonly known as adverse childhood experiences (ACEs), are traumatic events that occur during childhood that undermine safety, stability, and bonding (Centers for Disease Control, 2020; Hughes et al., 2017). Adverse childhood experiences (ACEs) have a considerable impact in the development of youth and increase the likelihood of developing poor health outcomes across the life span. (Centers for Disease Control, 2020; Hughes et al., 2017). Recently, researchers have argued that studies on ACEs do not account for the totality of individual experiences, particularly for racial-ethnic minority groups as experiences of racial discrimination are common occurrences beginning in childhood (Bernard et al., 2020; Merksy et al., 2021; Richards et al., 2021). Racial discrimination refers to interpersonal experiences of unfair treatment based on racial, ethnic, or ancestral characteristics (Williams et al., 2003). Racial discrimination is the enactment of racism, a cultural system of values, symbols, and institutions established by the racially dominant group to subordinate other racial groups (Bonilla-Silva, 2006).

Similar to ACEs, racial discrimination has been associated with negative health outcomes ranging from depressive symptoms to obesity and mortality, yet little research has established how racial discrimination compares among ACEs with health. As such, researchers have argued that for racial-ethnic minority children and adolescents, racial discrimination should be considered an ACE (Bernard et al., 2020).

To compare the magnitude of effect sizes between racial discrimination and health with ACEs and health, we conducted two systematic reviews to gather robust evidence to elucidate how racial discrimination’s association with behavior problems compares to the association between ACEs and behavior problems among racial-ethnic minority children and adolescents (see Figure 1). Specifically, we focus on the behavioral outcomes externalizing behaviors and internalizing symptoms. Typically, externalizing behaviors are externally focused and include aggression, poor impulse control, and delinquent behaviors. In contrast, internalizing symptoms are over-inhibited symptoms and include anxiety, somatic complaints, and sadness (Willner et al., 2016). Our results suggest that racial discrimination is more harmful on internalizing and externalizing symptoms compared to many common ACEs (see Figure 2).

We found that racial discrimination ranked 5th largest adverse experience for externalizing behaviors (out of 10) and 6th largest for internalizing symptoms (out of 12). Further, using Zou’s (2007) method for approximating confidence intervals of the difference between correlations, we found evidence that the association of racial discrimination is greater than ACEs including neglect, family conflict, domestic violence, and abuse.

This evidence emphasizes the impact of racial discrimination as an ACE in the development of behavior problems, showing the need for anti-racist research, policy, and practice. Our findings represent an opportunity to overcome a color-blind approach to addressing and treating ACEs, which often lacks acknowledgement of racism-related stress, denies the impact of racism, and erases the experience of children and youth of color, to one of cultural consciousness that recognizes the deleterious effects of both racial discrimination and ACEs on the development of racial-ethnic minority children and adolescents (Bernard et al., 2020).

Authors

• Kamryn S Morris, Arizona State University
  Presenting Author

• Joyce Yoo

• Kevin Michael Korous, GDIT

• José M. Causadias, Arizona State University