Assessing and Addressing Community-Level Adverse Childhood Experiences Among Black Youth Restricted; Files Only
Knutzen, Kristin (Spring 2026)
Abstract
Background: Due to structural racism Black youth disproportionately experience community-level adverse childhood experiences (ACEs) including witnessing community violence, living in unsafe neighborhoods, and experiencing racism, bullying, or foster care. Yet, the patterns and outcomes of community-level ACEs are understudied, as are strategies for prevention. To address these gaps, this research investigated how community-level ACEs impact Black youth to identify strategies to address and prevent these experiences through policy and practice.
Methods: In Study 1, latent class, descriptive, and linear regression analyses were conducted using quantitative data from Black, American Indian, and Hispanic/Latino youth to identify patterns of community-level ACEs, ethno-racial representation among latent classes, and association between latent classes and health and behavior outcomes. To contextualize these findings, Study 2 utilized a community-based participatory research approach to qualitatively analyze interview data from community shareholders regarding the needs of Black youth exposed to community-level ACEs and priorities for prevention. Informed by this work, Study 3 qualitatively analyzed focus group data from caregivers of Black youth impacted by gun violence to explore their experiences with economic disenfranchisement and economic support policies to better understand how structural factors influence community-level ACEs.
Results: Black youth are disproportionately likely to witness community violence and live in unsafe neighborhoods. Experiences of multi-level racism and including bullying are dependent on sociodemographic and political environments. Black youth exposed to community-level ACEs need access to culturally competent, affordable mental healthcare and opportunities for professional development. Structural investment in low income, Black neighborhoods and restructuring of economic policies to provide unrestricted support are needed to prevent community-level ACEs among Black youth.
Conclusions: These findings collectively indicate that Black youth have nuanced experiences of community-level ACEs, and that policy and practice changes are needed to address the consequences of community-level ACEs among Black youth and prevent them from occurring. Specifically, practice should adapt mental healthcare to be culturally competent for Black youth exposed to community-level ACEs, and policy change should increase career development opportunities for Black youth, increase neighborhood safety through structural investment, and increase economic stability through policy reform.
Table of Contents
1. Introduction
1.1. Adverse Childhood Experiences (ACEs) and Impact on Behavior and Health
1.2. Conventional ACEs and Structural Racism
1.3. Community-Level ACEs
1.3.1. Witnessing Community Violence
1.3.2. Living in an Unsafe Neighborhood
1.3.3. Living in Foster or Kinship Care
1.3.4. Experiencing Bullying Victimization
1.3.5. Experiencing Racial Discrimination
1.4. Need to Address Community-Level ACEs
1.5. Prevention of ACEs through Policy and Practice
1.6. Existing Practice and Gaps to Address
1.7. Existing Policy and Gaps to Address
1.8. Specific Aims
1.9. Application of Theory
1.10. Public Health Critical Race Praxis
1.11. Consolidated Framework for Implementation Research 2.0
2. Study 1: Latent Class Analysis of Community-Level Adverse Childhood Experiences Among Black, American Indian, and Hispanic/Latino Students and Associations with Behavioral Health Outcomes
2.1. Introduction
2.2. Methods
2.2.1. Setting and Participants
2.2.2. Procedures
2.2.3. Measures
2.2.4. Data Analysis
2.3. Results
2.3.1. Latent Class Analysis
2.3.2. Class Membership
2.3.3. Linear Regression Analysis
2.4. Discussion
3. Study 2: Addressing Community-Level Adverse Childhood Experiences Among Black Youth: Implications for Policy and Practice
3.1. Introduction
3.2. Methods
3.2.1. Setting and Participants
3.2.2. Data Collection
3.2.3. Measures
3.2.4. Data Analysis
3.3. Results
3.3.1. Experiencing Community Violence
3.3.2. Living in an Unsafe Neighborhood
3.3.3. Experience with Foster or Kinship Care
3.3.4. Experiencing Bullying
3.3.5. Experiencing Racism
3.3.6. Policy and Practice Solutions
3.4. Discussion
4. Study 3: Experiences of Economic Security Policies and Economic Disenfranchisement Among Caregivers of Black Youth Impacted by Gun Violence: Recommendations for Multilevel Change
4.1. Introduction
4.2. Methods
4.2.1. Setting and Participants
4.2.2. Data Collection
4.2.3. Measures
4.2.4. Data Analysis
4.3. Results
4.3.1. Economic support policies are conditional and reinforce hardship, limiting economic stability and social mobility
4.3.2. Intergenerational trauma and financial circumstance exacerbate economic disenfranchisement
4.3.3. Poverty deprives youth of resources and contributes to gun violence
4.3.4. Caregivers identified multilevel solutions for neighborhood safety and economic stability
4.4. Discussion
4.4.1. Strengths and Limitations
4.4.2. Conclusion
5. Discussion
5.1. Summary of Findings
5.2. Synthesis of Findings
5.3. Implications for Research
5.4. Implications for Practice
5.5. Implications for Policy
5.6. Strengths
5.7. Limitations
5.8. Conclusion
6. References
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File download under embargo until 27 May 2028 | 2026-05-01 12:20:59 -0400 | File download under embargo until 27 May 2028 |
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