Adverse childhood experiences among Hispanic and Latino Americans
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{{Essay-like|date=December 2021}}
Adverse childhood experiences (ACEs) are identified as serious and traumatizing experiences, such as abuse, neglect, exposure to violence, substance use, and other harmful events or situations that occur within a child's household or environment.{{Cite journal|last1=Shonkoff|first1=Jack P.|last2=Garner|first2=Andrew S.|last3=Committee on Psychosocial Aspects of Child and Family Health|last4=Committee on Early Childhood, Adoption, and Dependent Care|last5=Section on Developmental and Behavioral Pediatrics|date=2012-01-01|title=The lifelong effects of early childhood adversity and toxic stress|journal=Pediatrics|volume=129|issue=1|pages=e232–246|doi=10.1542/peds.2011-2663|issn=1098-4275|pmid=22201156|s2cid=535692|doi-access=free}} Unfortunately, exposure to ACEs within the child's community is all too common in low-income households and neighborhoods, with close to 43% of children in the United States (U.S.) living in low-income families.{{Cite web|title=Basic Facts about Low-Income Children: Children under 18 Years, 2016 – NCCP|url=https://www.nccp.org/publication/basic-facts-about-low-income-children-children-under-18-years-2016/|access-date=2021-11-18|language=en-US}} ACEs were first identified by the Centers for Disease Control and Prevention (CDC) and Kaiser Permanente's Adverse Childhood Experiences Study conducted from 1995 to 1997, where ACEs were examined and correlated with later-life well-being.{{Cite web|date=2021-05-21|title=About the CDC-Kaiser ACE Study {{!}}Violence Prevention{{!}}Injury Center{{!}}CDC|url=https://www.cdc.gov/violenceprevention/aces/about.html|access-date=2021-10-16|website=www.cdc.gov|language=en-us}} With one in four children experiencing or witnessing a potentially traumatic event, children who grow up in an unsafe environment are at risk for developing adverse health outcomes, affecting brain development, immune systems, and regulatory systems.{{Cite journal|last1=Holmes|first1=Cheryl|last2=Levy|first2=Michelle|last3=Smith|first3=Avis|last4=Pinne|first4=Susan|last5=Neese|first5=Paula|date=2015-06-01|title=A Model for Creating a Supportive Trauma-Informed Culture for Children in Preschool Settings|url=|journal=Journal of Child and Family Studies|language=en|volume=24|issue=6|pages=1650–1659|doi=10.1007/s10826-014-9968-6|issn=1573-2843|pmc=4419190|pmid=25972726}}{{Cite web|title=The Science of ACEs & Toxic Stress|url=https://www.acesaware.org/ace-fundamentals/the-science-of-aces-toxic-stress/|access-date=2021-10-16|website=ACEs Aware|language=en}}
Further research on ACEs determined that children who experience them are more likely than their similar-aged peers to experience challenges in their biological, emotional, social, and cognitive functioning.{{Cite journal|last1=Chu|first1=Ann T.|last2=Lieberman|first2=Alicia F.|date=2010-03-01|title=Clinical Implications of Traumatic Stress from Birth to Age Five|url=https://www.annualreviews.org/doi/10.1146/annurev.clinpsy.121208.131204|journal=Annual Review of Clinical Psychology|volume=6|issue=1|pages=469–494|doi=10.1146/annurev.clinpsy.121208.131204|pmid=20192799|issn=1548-5943|url-access=subscription}} Also, children who have experienced an ACE are at higher risk of being re-traumatized or suffering multiple ACEs.{{Cite journal|last1=Benedini|first1=Kristen M.|last2=Fagan|first2=Abigail A.|last3=Gibson|first3=Chris L.|date=2016-09-01|title=The cycle of victimization: The relationship between childhood maltreatment and adolescent peer victimization|url=|journal=Child Abuse & Neglect|language=en|volume=59|pages=111–121|doi=10.1016/j.chiabu.2016.08.003|pmid=27568065|issn=0145-2134}} The amount and types of ACEs can cause significant negative impacts and increase the risk of internalizing and externalizing in children.{{Cite journal|last1=Hagan|first1=Melissa J.|last2=Sulik|first2=Michael J.|last3=Lieberman|first3=Alicia F.|date=2016-07-01|title=Traumatic Life Events and Psychopathology in a High Risk, Ethnically Diverse Sample of Young Children: A Person-Centered Approach|url=|journal=Journal of Abnormal Child Psychology|language=en|volume=44|issue=5|pages=833–844|doi=10.1007/s10802-015-0078-8|pmid=26354023|s2cid=13879564|issn=1573-2835}}
To date, there is still limited research on how ACEs impact Latino children. As of 2019, there were nearly 61 million Latino individuals in the U.S.{{Cite web|last1=Noe-Bustamante|first1=Luis|last2=Lopez|first2=Mark Hugo|last3=Krogstad|first3=Jens Manuel|title=U.S. Hispanic population surpassed 60 million in 2019, but growth has slowed|url=https://www.pewresearch.org/fact-tank/2020/07/07/u-s-hispanic-population-surpassed-60-million-in-2019-but-growth-has-slowed/|access-date=2021-11-17|website=Pew Research Center|language=en-US}} With the Latino population becoming one of the largest minority groups within the U.S., it is crucial to examine how ACEs negatively impact Latino children's development and develop ways to reduce the rate at which ACEs are experienced in this population.{{Cite web |last= |first= |date=2017-08-31 |title=Facts for Features: Hispanic Heritage Month 2017 |url=https://www.census.gov/newsroom/facts-for-features/2017/hispanic-heritage.html |access-date=2021-10-17 |website=United States Census Bureau}}
Latino Americans Trauma Experiences
When it comes to trauma, Latino children are at higher risk, almost twice as much, than their white peers of experiencing ACEs. Also, they are at higher risk of developing posttraumatic stress disorder (PTSD) or PTSD symptoms due to increased challenges that these families face. Challenges include immigration, discrimination, violence, low socioeconomic status (SES), alcohol and substance use.{{Cite journal|last1=LaBrenz|first1=Catherine A.|last2=Panisch|first2=Lisa S.|last3=Lawson|first3=Jennifer|last4=Borcyk|first4=Amber L.|last5=Gerlach|first5=Beth|last6=Tennant|first6=Patrick S.|last7=Nulu|first7=Swetha|last8=Faulkner|first8=Monica|date=2020-05-01|title=Adverse Childhood Experiences and Outcomes among At-Risk Spanish-Speaking Latino Families|url=|journal=Journal of Child and Family Studies|language=en|volume=29|issue=5|pages=1221–1235|doi=10.1007/s10826-019-01589-0|s2cid=204395025|issn=1573-2843}}{{Cite journal|last1=Suarez-Morales|first1=Lourdes|last2=Mena|first2=Maite|last3=Schlaudt|first3=Victoria A.|last4=Santisteban|first4=Daniel A.|date=2017-05-01|title=Trauma in Hispanic youth with psychiatric symptoms: Investigating gender and family effects|journal=Psychological Trauma: Theory, Research, Practice and Policy|volume=9|issue=3|pages=334–343|doi=10.1037/tra0000216|issn=1942-969X|pmc=5411305|pmid=27797565}} Many U.S.-born Latino children have a foreign-born parent who is considered an unauthorized immigrant, presenting many challenges for the family.{{Cite web|last1=Passel|first1=Jeffrey S.|last2=Cohn|first2=D’Vera|last3=Krogstad|first3=Jens Manuel|last4=Gonzalez-Barrera|first4=Ana|date=2014-09-03|title=As Growth Stalls, Unauthorized Immigrant Population Becomes More Settled|url=https://www.pewresearch.org/hispanic/2014/09/03/as-growth-stalls-unauthorized-immigrant-population-becomes-more-settled/|access-date=2021-10-17|website=Pew Research Center's Hispanic Trends Project|language=en-US}} For children who have migrated to the U.S. with their families are at higher risk of experiencing traumatic events, as they tend to experience trauma in their home country and during their migration and settlement to the U.S.{{Cite journal|last1=Cleary|first1=Sean D.|last2=Snead|first2=Ryan|last3=Dietz-Chavez|first3=Daniela|last4=Rivera|first4=Ivonne|last5=Edberg|first5=Mark C.|date=2018-10-01|title=Immigrant Trauma and Mental Health Outcomes Among Latino Youth|url=|journal=Journal of Immigrant and Minority Health|language=en|volume=20|issue=5|pages=1053–1059|doi=10.1007/s10903-017-0673-6|issn=1557-1920|pmc=6436088|pmid=29139024}} Children who have undocumented parents, their chances of ACEs are further elevated since they may witness their parents being arrested, detained, or deported for being undocumented.{{Cite journal|last1=Rojas-Flores|first1=Lisseth|last2=Clements|first2=Mari L.|last3=Hwang Koo|first3=J.|last4=London|first4=Judy|date=2017-05-01|title=Trauma and psychological distress in Latino citizen children following parental detention and deportation.|url=http://doi.apa.org/getdoi.cfm?doi=10.1037/tra0000177|journal=Psychological Trauma: Theory, Research, Practice, and Policy|language=en|volume=9|issue=3|pages=352–361|doi=10.1037/tra0000177|pmid=27504961|s2cid=4391287|issn=1942-969X|url-access=subscription}} With the increased stress that Latino families face because of the described challenges, there is a greater risk of gang involvement, exposure to substance use, mental health problems, harmful parenting practices, and medical difficulties.
Latino parents who have migrated to the U.S. tend to have less education and do not speak or understand English fluently. These barriers reduce their chances of finding stable and well-paying jobs, increasing the risk of low SES among this population.{{Cite journal|last1=Alink|first1=Lenneke R. A.|last2=Euser|first2=Saskia|last3=IJzendoorn|first3=Marinus H. van|last4=Bakermans-Kranenburg|first4=Marian J.|date=2013|title=Is elevated risk of child maltreatment in immigrant families associated with socioeconomic status? Evidence from three sources|url=|journal=International Journal of Psychology|language=fr|volume=48|issue=2|pages=117–127|doi=10.1080/00207594.2012.734622|pmid=23597011|issn=1464-066X}} With the increased amount of barriers with language, education, and low SES, Latino families’ stress may increase as they cannot access resources such as food assistance, health coverage, and mental health support, thereby increasing their likelihood of ACEs.{{Cite journal|last1=Luque|first1=John S.|last2=Soulen|first2=Grace|last3=Davila|first3=Caroline B.|last4=Cartmell|first4=Kathleen|date=2018-05-02|title=Access to health care for uninsured Latina immigrants in South Carolina|journal=BMC Health Services Research|volume=18|issue=1|pages=310|doi=10.1186/s12913-018-3138-2|issn=1472-6963|pmc=5930513|pmid=29716586 |doi-access=free }} There is minimal research on how ACEs impact children from Latino families because many of them may go unreported in fear of deportation or separation from the children.{{Cite journal|last1=Vaughn|first1=Michael G.|last2=Salas-Wright|first2=Christopher P.|last3=Huang|first3=Jin|last4=Qian|first4=Zhengmin|last5=Terzis|first5=Lauren D.|last6=Helton|first6=Jesse J.|date=2017-05-01|title=Adverse Childhood Experiences Among Immigrants to the United States|url=|journal=Journal of Interpersonal Violence|language=en|volume=32|issue=10|pages=1543–1564|doi=10.1177/0886260515589568|pmid=26112971|s2cid=13328926|issn=0886-2605}}
Intimate and domestic violence is another example of an ACE that many Latino families face. Within this population, gender roles are clearly defined and implemented within the family dynamic. It is culturally expected that men present as powerful and dominant while women are submissive and self-sacrificing.{{Cite journal|last1=Perilla|first1=Julia L.|last2=Bakeman|first2=Roger|last3=Norris|first3=Fran H.|date=1994-01-01|title=Culture and Domestic Violence: The Ecology of Abused Latinas|journal=Violence and Victims|language=en|volume=9|issue=4|pages=325–339|doi=10.1891/0886-6708.9.4.325|pmid=7577760|s2cid=46131579|issn=0886-6708}} Due to these gender roles and the transmission of these cultural roles, women tend to give in to their partner's power and endure various forms of violence.{{Cite journal|last1=Fuchsel|first1=Catherine L. Marrs|last2=Murphy|first2=Sharon B.|last3=Dufresne|first3=Rebecca|date=2012-08-01|title=Domestic Violence, Culture, and Relationship Dynamics Among Immigrant Mexican Women|url=http://journals.sagepub.com/doi/10.1177/0886109912452403|journal=Affilia|language=en|volume=27|issue=3|pages=263–274|doi=10.1177/0886109912452403|s2cid=145270662|issn=0886-1099|url-access=subscription}} For many Latino women, incidents of domestic violence go unreported due to fear of affecting family cohesion, police involvement, deportation, and feelings of shame, embarrassment and criticism that they may endure from the extended family and community.{{Cite journal|last1=Fettes|first1=Danielle L.|last2=Aarons|first2=Gregory A.|last3=Brew|first3=Valerie|last4=Ledesma|first4=Karla|last5=Silovsky|first5=Jane|date=2020-10-08|title=Implementation of a trauma-informed, evidence-informed intervention for Latinx families experiencing interpersonal violence and child maltreatment: protocol for a pilot randomized control trial of SafeCare+®|journal=Pilot and Feasibility Studies|volume=6|issue=1|pages=153|doi=10.1186/s40814-020-00681-3|issn=2055-5784|pmc=7545833|pmid=33062294 |doi-access=free }} A longitudinal study showed that 45% of females and 50% of males reported having witnessed physical violence between their parents during their childhood.{{Cite journal|last1=Fehringer|first1=Jessica A.|last2=Hindin|first2=Michelle J.|date=2009-04-01|title=Like Parent, Like Child: Intergenerational Transmission of Partner Violence in Cebu, the Philippines|journal=Journal of Adolescent Health|language=en|volume=44|issue=4|pages=363–371|doi=10.1016/j.jadohealth.2008.08.012|pmc=4181364|pmid=19306795}} With increased domestic violence observed in the home, Latino children are more likely to express or develop unhealthy coping skills and continue the transmission of violence in their own relationships.{{Cite journal|last1=Black|first1=David S.|last2=Sussman|first2=Steve|last3=Unger|first3=Jennifer B.|date=2010-06-01|title=A Further Look at the Intergenerational Transmission of Violence: Witnessing Interparental Violence in Emerging Adulthood|journal=Journal of Interpersonal Violence|language=en|volume=25|issue=6|pages=1022–1042|doi=10.1177/0886260509340539|issn=0886-2605|pmc=3705927|pmid=19801446}}
Latino children who experience ACEs such as incarceration, maltreatment, and interpersonal trauma are at heightened risk and susceptibility for substance use disorders (SUDs) in later life.{{Cite journal|last1=Villamil Grest|first1=Carolina|last2=Cederbaum|first2=Julie A.|last3=Lee|first3=Jungeun Olivia|last4=Unger|first4=Jennifer B.|date=2021-10-01|title=Adverse childhood experiences and the substance use behaviors of Latinx youth|url=|journal=Drug and Alcohol Dependence|language=en|volume=227|pages=108936|doi=10.1016/j.drugalcdep.2021.108936|pmid=34365223}}{{Cite journal|last1=Meulewaeter|first1=Florien|last2=De Pauw|first2=Sarah S. W.|last3=Vanderplasschen|first3=Wouter|date=2019-10-18|title=Mothering, Substance Use Disorders and Intergenerational Trauma Transmission: An Attachment-Based Perspective|journal=Frontiers in Psychiatry|volume=10|pages=728|doi=10.3389/fpsyt.2019.00728|issn=1664-0640|pmc=6813727|pmid=31681040|doi-access=free}} Research suggests that Latino children who experience household incarceration are at risk of increased binge drinking, marijuana use, and negative substance use consequences in emerging adulthood.{{Cite journal|last1=Grigsby|first1=Timothy J.|last2=Forster|first2=Myriam|last3=Davis|first3=Laurel|last4=Unger|first4=Jennifer B.|date=2020-08-03|title=Substance Use Outcomes for Hispanic Emerging Adults Exposed to Incarceration of a Household Member during Childhood|journal=Journal of Ethnicity in Substance Abuse|language=en|volume=19|issue=3|pages=358–370|doi=10.1080/15332640.2018.1511494|issn=1533-2640|pmc=6476701|pmid=30346915}} Those who do not experience household incarceration but experience accumulative ACEs are at increased odds of cigarette smoking. Latino children who experience maltreatment are 23% more likely to have problematic alcohol use in adulthood.
Protective Factors of ACEs
Protective factors are the variables within an individual or their community that help promote their well-being against adversity.{{Cite journal|last1=Banyard|first1=Victoria|last2=Hamby|first2=Sherry|last3=Grych|first3=John|date=2017-03-01|title=Health effects of adverse childhood events: Identifying promising protective factors at the intersection of mental and physical well-being|url=|journal=Child Abuse & Neglect|language=en|volume=65|pages=88–98|doi=10.1016/j.chiabu.2017.01.011|pmid=28131000|issn=0145-2134}} Although Latino families are at risk of experiencing more ACEs, research suggests that Latino cultural values can be protective factors to ACEs and long-term trauma.{{Cite journal|last1=Reyes|first1=Jazmin A.|last2=Elias|first2=Maurice J.|date=2011|title=Fostering social–emotional resilience among Latino youth|url=|journal=Psychology in the Schools|language=en|volume=48|issue=7|pages=723–737|doi=10.1002/pits.20580|issn=1520-6807}} Cultural values are the strong beliefs, traditions, and values that Latino holds firmly within their culture.{{Cite journal|last1=Gamoran|first1=Adam|last2=Turley|first2=Ruth N. López|last3=Turner|first3=Alyn|last4=Fish|first4=Rachel|date=2012-03-01|title=Differences between Hispanic and non-Hispanic families in social capital and child development: First-year findings from an experimental study|journal=Research in Social Stratification and Mobility|series=Inequality across the Globe|language=en|volume=30|issue=1|pages=97–112|doi=10.1016/j.rssm.2011.08.001|issn=0276-5624|pmc=3520493|pmid=23243331}} Cultural values include the traditional values of respect, religion, familial, and gender roles.{{Cite journal|last1=Knight|first1=George P.|last2=Gonzales|first2=Nancy A.|last3=Saenz|first3=Delia S.|last4=Bonds|first4=Darya D.|last5=Germán|first5=Miguelina|last6=Deardorff|first6=Julianna|last7=Roosav|first7=Mark W.|last8=Updegraff|first8=Kimberly A.|date=2010-06-01|title=The Mexican American Cultural Values Scale for Adolescents and Adults|url=|journal=The Journal of Early Adolescence|language=en|volume=30|issue=3|pages=444–481|doi=10.1177/0272431609338178|issn=0272-4316|pmc=2904976|pmid=20644653}} These cultural values are held in high regard in Latino culture and endorsed at a young age; without these values, families can experience increased levels of dysfunction.{{Cite journal|last1=Lorenzo-Blanco|first1=Elma I.|last2=Unger|first2=Jennifer B.|last3=Baezconde-Garbanati|first3=Lourdes|last4=Ritt-Olson|first4=Anamara|last5=Soto|first5=Daniel|date=2012-10-01|title=Acculturation, Enculturation, and Symptoms of Depression in Hispanic Youth: The Roles of Gender, Hispanic Cultural Values, and Family Functioning|url=|journal=Journal of Youth and Adolescence|language=en|volume=41|issue=10|pages=1350–1365|doi=10.1007/s10964-012-9774-7|issn=1573-6601|pmc=4511280|pmid=22627624}} Parents must transmit their children's cultural values to continue the culture.{{Cite journal|last1=Tsai|first1=Kim M.|last2=Telzer|first2=Eva H.|last3=Gonzales|first3=Nancy A.|last4=Fuligni|first4=Andrew J.|date=2015|title=Parental Cultural Socialization of Mexican-American Adolescents' Family Obligation Values and Behaviors|journal=Child Development|language=en|volume=86|issue=4|pages=1241–1252|doi=10.1111/cdev.12358|issn=1467-8624|pmc=4558414|pmid=25726966}} Children also learn about the culture's values through socialization with extended family members.{{Cite journal|last1=Perez-Brena|first1=Norma J.|last2=Updegraff|first2=Kimberly A.|last3=Umaña-Taylor|first3=Adriana J.|date=2015|title=Transmission of Cultural Values among Mexican-Origin Parents and Their Adolescent and Emerging Adult Offspring|journal=Family Process|language=en|volume=54|issue=2|pages=232–246|doi=10.1111/famp.12114|issn=1545-5300|pmc=4452439|pmid=25470657}}
Within the Latino population, family cohesion is embedded in the traditional cultural value known as familism.{{Cite journal|last1=Carlo|first1=Gustavo|last2=Koller|first2=Silvia|last3=Raffaelli|first3=Marcela|last4=de Guzman|first4=Maria R. T.|date=2007-08-28|title=Culture-Related Strengths Among Latin American Families|url=|journal=Marriage & Family Review|volume=41|issue=3–4|pages=335–360|doi=10.1300/J002v41n03_06|s2cid=7180350|issn=0149-4929}} In Latino culture, familism refers to the emotional bonding and supportiveness between family members, which leads to positive family functioning.{{Cite journal|last1=Birgisdóttir|first1=Dröfn|last2=Grenklo|first2=Tove Bylund|last3=Nyberg|first3=Tommy|last4=Kreicbergs|first4=Ulrika|last5=Steineck|first5=Gunnar|last6=Fürst|first6=Carl J.|date=2019|title=Losing a parent to cancer as a teenager: Family cohesion in childhood, teenage, and young adulthood as perceived by bereaved and non-bereaved youths|journal=Psycho-Oncology|language=en|volume=28|issue=9|pages=1845–1853|doi=10.1002/pon.5163|issn=1099-1611|pmc=6771813|pmid=31250504}} Within Latino culture, families must stick together and utilize family, both immediate and extended, as a support system, which ensures the children stay physically and psychologically healthy through social interactions and secure attachments with their family members. With an increased amount of support, the risk of parental stress experienced by Latino parents can be minimized, reducing the chances of ACE exposure. Family cohesion can be identified as a protective factor. For example, one study found that strong familial orientation among Latino families contributed to higher school success in Latino children.{{Cite journal|last1=Goodrum|first1=Nada M.|last2=Smith|first2=Daniel W.|last3=Hanson|first3=Rochelle F.|last4=Moreland|first4=Angela D.|last5=Saunders|first5=Benjamin E.|last6=Kilpatrick|first6=Dean G.|date=2020-11-01|title=Longitudinal Relations among Adolescent Risk Behavior, Family Cohesion, Violence Exposure, and Mental Health in a National Sample|url=|journal=Journal of Abnormal Child Psychology|language=en|volume=48|issue=11|pages=1455–1469|doi=10.1007/s10802-020-00691-y|issn=1573-2835|pmc=7530104|pmid=32845455}}
Research suggests that high family cohesion minimizes the risk of exposure to violence and negative mental health outcomes in adolescence and adulthood. Still, for some Latino families, family cohesion is not as vital, which can be detrimental to the family dynamic when ACEs are present.{{Cite journal|last1=Fong|first1=Hiu-fai|last2=Bennett|first2=Colleen E.|last3=Mondestin|first3=Valerie|last4=Scribano|first4=Philip V.|last5=Mollen|first5=Cynthia|last6=Wood|first6=Joanne N.|date=2020-11-01|title=The Impact of Child Sexual Abuse Discovery on Caregivers and Families: A Qualitative Study|url=|journal=Journal of Interpersonal Violence|language=en|volume=35|issue=21–22|pages=4189–4215|doi=10.1177/0886260517714437|pmid=29294788|s2cid=25413720|issn=0886-2605}} Those who do not have substantial cohesion levels in their environments are more likely to experience negative mental health outcomes such as depression, anxiety, and psychotic symptoms.{{Cite journal|last1=Solmi|first1=Francesca|last2=Colman|first2=Ian|last3=Weeks|first3=Murray|last4=Lewis|first4=Glyn|last5=Kirkbride|first5=James B.|date=2017-07-01|title=Trajectories of Neighborhood Cohesion in Childhood, and Psychotic and Depressive Symptoms at Age 13 and 18 Years|url=|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=56|issue=7|pages=570–577|doi=10.1016/j.jaac.2017.04.003|issn=0890-8567|pmc=5493518|pmid=28647008}} ACEs can lead to increased emotional and psychological distress in parents, which can negatively affect family cohesion. For this reason, it is essential to see how ACEs negatively impact family cohesion within the Latino population.