Researchers from the College of Liberal Arts and Sciences examined differences in childhood adversity between Black men and women and its impact on heart disease risk in adulthood
Lifestyle, environment, and genetics can shape heart disease risk, but a new study from UConn researchers explores how negative childhood incidents impact heart health in adulthood.
Ryan Talbert and Raja Staggers-Hakim, both assistant professors of sociology, and Jolaade Kalinowski, an assistant professor of human development and family sciences, published findings from a pilot study supported by UConn's Institute for Collaboration on Health, Intervention, and Policy (InCHIP) in the peer-reviewed journal Ethnicity and Health that explores the link between heart disease and harmful childhood experiences, like abuse, neglect, household substance abuse or mental illness, among Black Americans.
Talbert, Staggers-Hakim, and Kalinowski are all researchers who have expertise in stress, health, and health disparities research, investigating the effects systemic racism, white supremacy, and anti-Blackness on health. Their initial InCHIP-supported study looked at the effects of police violence on mental health for Black Americans.
As the team progressed in the project, they wanted to also capture additional adverse experiences happening in childhood to understand their effects on health later in life.
The Lasting Toll of Adverse Childhood Experiences on Health
There is a significant body of evidence showing that people who face negative events in childhood are more likely to have poorer health in adulthood. These potentially traumatic events have been linked to higher chances of cancer, skeletal fractures, and mental illness.
When it comes to heart disease, individuals who experience two to four or more negative events as children are twice as likely to develop heart disease or die prematurely. This may happen because trauma can activate the body's stress response, leading to nervous system dysfunction and inflammation.
There is little research that investigates how different adverse events in childhood impact the risk of heart disease in adulthood, and specifically how Black Americans' heart disease risk is affected by these experiences in childhood.
Heart disease is the leading cause of death for Americans, and data shows Black Americans are disproportionately burdened by it. This heightened risk is compounded by chronic and unavoidable stress, and limited access to protective resources, such as higher income, educational attainment, and quality healthcare.
Additionally, Black Americans are also more likely to experience multiple adverse events during childhood.
Insights From the Study
Talbert, Kalinowski, and Staggers-Hakim were interested in determining how exposure to adverse childhood experiences differed between Black men and women and if the effects on health would vary.
"While research shows that social factors contribute largely to Black-white disparities in heart disease, this study is one of few to investigate the role of adverse childhood experiences for risk of heart disease specifically among Black populations. We compared Black men to other Black men, and Black women to other Black women to identify differences among groups with similar social status rather than comparing groups with different social status," says Talbert, the study's lead author.
They analyzed data from the U.S. Centers for Disease Control and Prevention's (CDC) Behavioral Risk Factor Surveillance System collected between 2019 and 2022 to determine how exposure to adverse events during childhood impacted heart disease risk later in life.
Data was collected from 41 states and Washington, D.C., The analytic sample size was 30,746.
About 3% of Black women and 4% of Black men in the sample had heart disease. Of this, men were more likely to have experienced physical abuse, divorced parents, and an imprisoned household member in childhood. Women on the other hand were more likely to have experienced household mental illness and sexual violence, including rape, abuse, and coercion. The team also found that Black women who experienced two or more adverse events in childhood had a higher risk of developing heart disease.
Additionally, men who grew up in households where someone was imprisoned or abused drugs were more likely to have heart disease as adults. Both women and men who grew up in households with drug use or mental illness, and sexual violence had higher odds of heart disease in adulthood.
"These differences suggest there is not a one-size-fits-all solution to how we respond to adverse childhood events," says Talbert.
The Costs of Childhood Adversity
Beyond individual health, these kinds of childhood experiences also have economic and social consequences.
"Adverse childhood experiences have extensive economic, psychological, and social costs. Identifying ways to reduce ACEs would save people, policymakers, and governments money," says Talbert.
About 63% of U.S. adults have experienced potentially traumatic events in childhood, and about two-thirds have experienced more than two. The cost of health conditions stemming from these events totals $14.1 trillion a year in direct medical spending and lost life. Individually, these events can cost about $2.4 million over the course of one's life.
According to 2021 data from the CDC, a 10% reduction in these events would produce $56 billion in savings annually.
The study underscores the importance of understanding how heart disease risk differs by race and gender, and how adverse incidents in childhood influence heart health later.
A Path Toward Improved Health
The findings have implications for policy and practice.
They highlight the need for assessing and tracking harmful childhood experiences, including exposure to racial discrimination.
"Despite the potential trauma extending from early life adversities, Black children and adults are often resilient in the face of these events underscoring the power of culturally relevant and empowering coping strategies. Understanding these strategies could help inform more effective responses to adverse childhood experiences and their consequences," says Talbert.
Improving evaluation strategies can illuminate patterns in exposure and inform more effective prevention and intervention strategies to reduce their long-term impacts. Interventions that target the underlying causes of detrimental childhood events and experiences could help prevent them in the first place, improving health outcomes more broadly. These strategies include expanding access to affordable housing, healthcare, and quality education.
"Access to high-quality, trauma-informed, and culturally competent mental health care remains a first line of defense but is often misaligned with need due to inequalities in insurance coverage, digital infrastructure, and transportation," says Talbert.
