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Am J Prev Med. 2016 Jan;50(1):47-56. doi: 10.1016/j.amepre.2015.06.013. Epub 2015 Sep 2.

Racial Disparities in Child Adversity in the U.S.: Interactions With Family Immigration History and Income.

Author information

1
Department of Epidemiology and Biostatistics, University of Maryland College Park, School of Public Health, College Park, Maryland. Electronic address: nslopen@umd.edu.
2
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Center on the Developing Child, Harvard University, Cambridge, Massachusetts; Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts; Harvard Graduate School of Education, Cambridge, Massachusetts.
3
University of California, San Francisco, School of Medicine, San Francisco, California.
4
Department of Applied Psychology, New York University, New York, New York.
5
Georgetown University Medical Center, Washington, District of Columbia.
6
Center on the Developing Child, Harvard University, Cambridge, Massachusetts.
7
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.

Abstract

INTRODUCTION:

Childhood adversity is an under-addressed dimension of primary prevention of disease in children and adults. Evidence shows racial/ethnic and socioeconomic patterning of childhood adversity in the U.S., yet data on the interaction of race/ethnicity and SES for exposure risk is limited, particularly with consideration of immigration history. This study examined racial/ethnic differences in nine adversities among children (from birth to age 17 years) in the National Survey of Child Health (2011-2012) and determined how differences vary by immigration history and income (N=84,837).

METHODS:

We estimated cumulative adversity and individual adversity prevalences among white, black, and Hispanic children of U.S.-born and immigrant parents. We examined whether family income mediated the relationship between race/ethnicity and exposure to adversities, and tested interactions (analyses conducted in 2014-2015).

RESULTS:

Across all groups, black and Hispanic children were exposed to more adversities compared with white children, and income disparities in exposure were larger than racial/ethnic disparities. For children of U.S.-born parents, these patterns of racial/ethnic and income differences were present for most individual adversities. Among children of immigrant parents, there were few racial/ethnic differences for individual adversities and income gradients were inconsistent. Among children of U.S.-born parents, the Hispanic-white disparity in exposure to adversities persisted after adjustment for income, and racial/ethnic disparities in adversity were largest among children from high-income families.

CONCLUSIONS:

Simultaneous consideration of multiple social statuses offers promising frameworks for fresh thinking about the distribution of disease and the design of targeted interventions to reduce preventable health disparities.

PMID:
26342634
DOI:
10.1016/j.amepre.2015.06.013
[Indexed for MEDLINE]

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