An update on ACEs domain frequencies across race/ethnicity and sex in a nationally representative sample

Background: Adverse childhood experiences (ACEs) research has yielded important information regarding ACEs prevalence and impacts; however, few studies have included American Indian/Alaska Native (AI/AN) populations. Objective: We aimed to update and expand the ACEs literature by using recent data (2009-2018; over 50% from 2015 to 2017); using a large, nationally representative sample (total N = 166,606) and AI/AN sub-sample (N = 3369); and including additional covariates (i.e., sex, age, income, education) to provide a comprehensive understanding of ACEs across diverse populations. Participants and setting: Data were from the CDC's BRFSS, a standardized scale used in most ACEs literature, to improve generalizability of study findings, which may contribute to investigating future ACEs trends. Methods: Descriptive statistics and negative binomial regression analyses were conducted to examine the frequency of ACEs and the eight ACEs domains across racial/ethnic and sex groups. Results: AI/ANs had the highest ACEs compared to all racial/ethnic groups. Females had higher mean ACEs compared to males of the same racial/ethnic group; significant differences were identified between non-Hispanic White (NHW) females and NHW males, and between Hispanic females and Hispanic males. Across all 10 stratified subgroups, AI/AN females had the highest average ACEs followed by AI/AN males. Emotional abuse was the most reported ACEs domain across all individuals, and family incarceration was the lowest. AI/AN females and males had the highest ACEs frequencies in family substance use, witnessing intimate partner violence, and sexual and emotional abuse. Conclusions: Findings have important implications for public health intervention and prevention efforts that may mitigate the impact of ACEs across racial/ethnic groups, particularly for AI/AN populations.