Adverse Childhood Experiences (ACE) Scores and the Latino Community

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8th Feb 2020 Health And Social Care Reference this

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Adverse Childhood Experiences (ACE) Scores and

the Latino Community

Specific Aims 

  Previous research has found that there is a relationship between a child’s Adverse Childhood Experiences (ACE) Scores and mental diseases that may develop over the lifetime (Harris 2014). However, the literature doesn’t provide information on whether the Latino community is at a greater risk for high ACE Scores. This study proposal tries to examine the relationship between underrepresented Latinos (Afro-Caribbean or Central American descent) and how their ACE Scores may have an impact on future well-being.

Introduction 

 In 1998, a group of doctors at the CDC and Kaiser Permanente in California came together to produce what today is known as the Adverse Childhood Experiences Questionnaire. They formulated this survey to determine what the connection was between early childhood adversity and health risks developed later in life. The early consensus was that the survey would be conducted with children, however as the authors of the research and questionnaire found, the ACE survey could be conducted on adults to determine how their previously diagnosed mental disorders were attributed to their childhood experiences (Felitti & Anda, 1996).

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 The researchers of the original ACE study, named the Relationship of Childhood Abuse and Household Dysfunction: The Adverse Childhood Experiences (ACE) Study, found that almost half of the 13,000 adults that they surveyed reported to have at least one ACE Score. One fourth of the sample tested had reported at least two or more ACEs (Felitti et al., 1998). As the number of ACE’s increased, individuals were shown to be more likely to have an innumerous list of health and socioeconomic disparities. The basis of the study was 70% Caucasian and 70% of the original group were college educated. These early groups were found to provide a basis for further research on how the ACE Questionnaire could determine a child’s risk for mental or physiological disorders later in their life. Additionally, a recent study found that individuals who had a score of 6 or more were considered to be on track for failure in cognitive development and social skills (Harris, 2014). Those who received a score higher than 4 were at a higher risk of developing depression or anxiety in their lifetime (Harris, 2014). However, limited information on how the ACE Questionnaire could be used with young adults or college students.

 Although we know that alcohol and substance abuse is rampant across all ethnic and racial groups, within the Latino community the statistics show that Mexican-Americans are one of the most reported and studied upon group in research. This poses a problem for researchers who want to use the information that we have on the Latino community to generalize to other groups such as Puerto Ricans, Cubans, and other Latinos. Many studies in the literature fail to examine how those Latinos of Central American or Afro-Caribbean descent may be impacted by ACEs and what the general outcomes of these individuals’ lives are. Since the first waves of migration to the U.S, many Latinos have faced hardships when migrating. One issue that seems to always arise within the Latino community is the abuse of substances, specifically alcohol and tobacco abuse. Throughout Latino history, many have pegged the community as purveyors of cannabis use and delinquency. However, a closer look at this group of people shows a greater awareness is needed in order for the community to overcome alcohol and substance abuse and/or addiction. Starting from the age of 16, many Latino teenagers find themselves consuming alcohol as early as 9th grade. These erroneous behaviors continue on through adolescence into adulthood, when erroneous behaviors disrupt the lives of these individuals across many sectors of their lives.

  When research with the ACE’s was conducted with high school students, they found that when students had a higher ACE score and had been previously exposed to drinking alcohol at an early age, the intention to delay alcohol consumption before the age of 21was thwarted. (Dube, Miller, Brown, 2006). The researchers determined that the ACE Score of the student must be taken into account when preventative measures for alcohol and smoking were involved. These case studies focus on the impact ACE’s have on college students and high school students, but there is again limited research on how the ACE score of a Latino child may be affected by these situations. Our research seeks to find the relationship between the ACE score of a Latino family and how the socioeconomic status of the family might be affected by their ACEs.

Current Study

 This study will actively seek out families from a generally underrepresented Latino background to participate in the ACE measure. Recruiters will post advertisements for the study across social media boards, as well as flyers to be placed in communal spaces such as churches, elementary and middle schools, community centers for the elderly and bodegas. Flyer would ideally be posted within Latino communities around the greater New York City area, however online submission into the study would also be considered.

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 We will be using the Adverse Childhood Experiences Questionnaire (Felitti et el., 1998) to determine the ACE Scores of the participants. The questionnaire consists of ten questions, each one relating to trauma or experiences that happened during the participants current or past childhood. The scoring is based off of how many questions are answered with yes. An ACE Score of eight is considered the cutoff. Any participant who answers yes to more than eight questions are placed in the same category with those with a score of eight. We will also be administering questions about the age of the participants as well as questions on ethnicity, household income and amount, as well as sex, gender and socioeconomic status.

 For ethnicity, participant families will be asked to identify from a list of countries that are predominantly Spanish speaking countries in the Caribbean and Central America. Options on the list will include: Puerto Rico, Cuba, the Dominican Republic, Mexico, Guatemala, Honduras, El Salvador, Nicaragua, and Costa Rica. If participants feel that their ethnicity has not been represented, then they will be given the option for “other” to describe what ethnicity they subscribe to. Our participants would be divided into four cross sectional age groups; the first group would consist of children between the ages of 1 and 11, the second adolescents between the ages of 12 and 17, adults between 18 to 50 and elderly adults ranging till 80. These groups would then be analyzed to determine what the average ACE score for each group was. Data on the participants age, ethnicity, education, and income would then be correlated against their ACE scores and ages to determine how ACE scores may have an effect on these demographics. Other factors such as mental and physical health could also be run against their ACE score to determine how this could also be affected.

Innovation

 Our study would be satisfactory in providing basic demographics on the sample of Afro-Caribbean and Central American descent. the results of our study can be beneficial to the administration at Hunter College. Knowledge on the ACE Score can help universities, job forces and institutions determine how an individual of Latino descent can be served based off of their score. If an incoming freshman at a university is classified as having an ACE Score of four, the academic counseling department on campuses can further assess the needs of that student and helping them to reach their projected graduation year on time. Also, ACE Scores could serve useful for the financial aid department. A student who has a generally higher ACE Score can be guided on how to pay for college in a holistic manner, as well as guided sessions on fears or worries about financial planning.

 Our study could also be beneficial for the modern workforce. Employers may find that when looking for new hires, an ACE score may be beneficial in determining what types of candidates they would like to hire. In therapy, psychologists may be able to use a client’s ACE score as a basis for therapeutic treatment of Latino background. Our study will add pertinent information to the literature not only on ACE scores across a wider range of individuals, but also tackle the mental health disparities that plague the Latino community.

References

Adverse Childhood Experiences (ACE) Scores and

the Latino Community

Specific Aims 

  Previous research has found that there is a relationship between a child’s Adverse Childhood Experiences (ACE) Scores and mental diseases that may develop over the lifetime (Harris 2014). However, the literature doesn’t provide information on whether the Latino community is at a greater risk for high ACE Scores. This study proposal tries to examine the relationship between underrepresented Latinos (Afro-Caribbean or Central American descent) and how their ACE Scores may have an impact on future well-being.

Introduction 

 In 1998, a group of doctors at the CDC and Kaiser Permanente in California came together to produce what today is known as the Adverse Childhood Experiences Questionnaire. They formulated this survey to determine what the connection was between early childhood adversity and health risks developed later in life. The early consensus was that the survey would be conducted with children, however as the authors of the research and questionnaire found, the ACE survey could be conducted on adults to determine how their previously diagnosed mental disorders were attributed to their childhood experiences (Felitti & Anda, 1996).

 The researchers of the original ACE study, named the Relationship of Childhood Abuse and Household Dysfunction: The Adverse Childhood Experiences (ACE) Study, found that almost half of the 13,000 adults that they surveyed reported to have at least one ACE Score. One fourth of the sample tested had reported at least two or more ACEs (Felitti et al., 1998). As the number of ACE’s increased, individuals were shown to be more likely to have an innumerous list of health and socioeconomic disparities. The basis of the study was 70% Caucasian and 70% of the original group were college educated. These early groups were found to provide a basis for further research on how the ACE Questionnaire could determine a child’s risk for mental or physiological disorders later in their life. Additionally, a recent study found that individuals who had a score of 6 or more were considered to be on track for failure in cognitive development and social skills (Harris, 2014). Those who received a score higher than 4 were at a higher risk of developing depression or anxiety in their lifetime (Harris, 2014). However, limited information on how the ACE Questionnaire could be used with young adults or college students.

 Although we know that alcohol and substance abuse is rampant across all ethnic and racial groups, within the Latino community the statistics show that Mexican-Americans are one of the most reported and studied upon group in research. This poses a problem for researchers who want to use the information that we have on the Latino community to generalize to other groups such as Puerto Ricans, Cubans, and other Latinos. Many studies in the literature fail to examine how those Latinos of Central American or Afro-Caribbean descent may be impacted by ACEs and what the general outcomes of these individuals’ lives are. Since the first waves of migration to the U.S, many Latinos have faced hardships when migrating. One issue that seems to always arise within the Latino community is the abuse of substances, specifically alcohol and tobacco abuse. Throughout Latino history, many have pegged the community as purveyors of cannabis use and delinquency. However, a closer look at this group of people shows a greater awareness is needed in order for the community to overcome alcohol and substance abuse and/or addiction. Starting from the age of 16, many Latino teenagers find themselves consuming alcohol as early as 9th grade. These erroneous behaviors continue on through adolescence into adulthood, when erroneous behaviors disrupt the lives of these individuals across many sectors of their lives.

  When research with the ACE’s was conducted with high school students, they found that when students had a higher ACE score and had been previously exposed to drinking alcohol at an early age, the intention to delay alcohol consumption before the age of 21was thwarted. (Dube, Miller, Brown, 2006). The researchers determined that the ACE Score of the student must be taken into account when preventative measures for alcohol and smoking were involved. These case studies focus on the impact ACE’s have on college students and high school students, but there is again limited research on how the ACE score of a Latino child may be affected by these situations. Our research seeks to find the relationship between the ACE score of a Latino family and how the socioeconomic status of the family might be affected by their ACEs.

Current Study

 This study will actively seek out families from a generally underrepresented Latino background to participate in the ACE measure. Recruiters will post advertisements for the study across social media boards, as well as flyers to be placed in communal spaces such as churches, elementary and middle schools, community centers for the elderly and bodegas. Flyer would ideally be posted within Latino communities around the greater New York City area, however online submission into the study would also be considered.

 We will be using the Adverse Childhood Experiences Questionnaire (Felitti et el., 1998) to determine the ACE Scores of the participants. The questionnaire consists of ten questions, each one relating to trauma or experiences that happened during the participants current or past childhood. The scoring is based off of how many questions are answered with yes. An ACE Score of eight is considered the cutoff. Any participant who answers yes to more than eight questions are placed in the same category with those with a score of eight. We will also be administering questions about the age of the participants as well as questions on ethnicity, household income and amount, as well as sex, gender and socioeconomic status.

 For ethnicity, participant families will be asked to identify from a list of countries that are predominantly Spanish speaking countries in the Caribbean and Central America. Options on the list will include: Puerto Rico, Cuba, the Dominican Republic, Mexico, Guatemala, Honduras, El Salvador, Nicaragua, and Costa Rica. If participants feel that their ethnicity has not been represented, then they will be given the option for “other” to describe what ethnicity they subscribe to. Our participants would be divided into four cross sectional age groups; the first group would consist of children between the ages of 1 and 11, the second adolescents between the ages of 12 and 17, adults between 18 to 50 and elderly adults ranging till 80. These groups would then be analyzed to determine what the average ACE score for each group was. Data on the participants age, ethnicity, education, and income would then be correlated against their ACE scores and ages to determine how ACE scores may have an effect on these demographics. Other factors such as mental and physical health could also be run against their ACE score to determine how this could also be affected.

Innovation

 Our study would be satisfactory in providing basic demographics on the sample of Afro-Caribbean and Central American descent. the results of our study can be beneficial to the administration at Hunter College. Knowledge on the ACE Score can help universities, job forces and institutions determine how an individual of Latino descent can be served based off of their score. If an incoming freshman at a university is classified as having an ACE Score of four, the academic counseling department on campuses can further assess the needs of that student and helping them to reach their projected graduation year on time. Also, ACE Scores could serve useful for the financial aid department. A student who has a generally higher ACE Score can be guided on how to pay for college in a holistic manner, as well as guided sessions on fears or worries about financial planning.

 Our study could also be beneficial for the modern workforce. Employers may find that when looking for new hires, an ACE score may be beneficial in determining what types of candidates they would like to hire. In therapy, psychologists may be able to use a client’s ACE score as a basis for therapeutic treatment of Latino background. Our study will add pertinent information to the literature not only on ACE scores across a wider range of individuals, but also tackle the mental health disparities that plague the Latino community.

References

  • About the CDC-kaiser ACE study. (June 16, 2016). Retrieved from https://www.cdc.gov/violenceprevention/acestudy/about.html
  • Dube, S. R., Miller, J. W., Brown, D. W., Giles, W. H., Felitti, V. J., Dong, M., & Anda, R. F. (2006). Adverse childhood experiences and the association with ever using alcohol and initiating alcohol use during adolescencedoi:https://doi.org/10.1016/j.jadohealth.2005.06.006
  • Felitti, V. J. (2002). The relationship of adverse childhood experiences to adult health: Turning gold into lead / belastungen in der kindheit und gesundheit im erwachsenenalter: Die verwandlung von gold in blei. Zeitschrift Für Psychosomatische Medizin Und Psychotherapie, 48(4), 359-369.
  • Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., . . . Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ACE) study doi:https://doi.org/10.1016/S0749-3797(98)00017-8
  • Harris, N. B. (2014). How childhood trauma affects health across a lifetime. Tedmed.
  • Kim, Y. H. (2017). Associations of adverse childhood experiences with depression and alcohol abuse among korean college students doi:https://doi.org/10.1016/j.chiabu.2017.03.009
  • McCauley, J., Kern, D. E., Kolodner, K., Dill, L., Schroeder, A. F., DeChant, H. K., . . . Bass, E. B. (1997). Clinical characteristics of women with a history of childhood abuse: Unhealed wounds. Jama, 277(17), 1362-1368.
  • Roesler, T. A., & McKENZIE, N. (1994). Effects of childhood trauma on psychological functioning in adults sexually abused as children. The Journal of Nervous and Mental Disease, 182(3), 145-150.

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