Emotional determinants of health: exploring prevalence and the impact of adverse childhood experiences on physical and mental health outcomes of black adult men using the 2012 behavioral risk factor surveillance system
Background. In the United States, Black men face a disproportionate burden of preventable mortality and morbidity rates. Among the possible factors associated with the disproportionality in these rates among Black men, studies suggest, are adverse childhood experiences (ACEs). Moreover, depression, one of the world’s most pervasive psychiatric disorders, researchers suggest, also contributes to disparate mortality and morbidity rates among Black men. Purpose. The purpose of this study and research inquiry was to describe the relationship between differential exposure to ACE’s and depression in Black men, controlling for effects of social demographic factors, presence of chronic medical conditions, and behavioral health risks using the 2012 Behavioral Risk Factor Surveillance System (BRFSS) data. Methods. A secondary data analysis was employed using a community sample of 3,084 Black men originating from the 2012 BRFSS. The 2012 BRFSS included an ACE module questionnaire. ACE module survey questions were used to determine the presence (yes/no) for types (e.g., direct or environmental) of ACEs. Composite measures of the ACE type subscales were computed to determine the total number of ACEs that could be reported (e.g., range 0 to ≥ 5). Additional BRFSS questions assessed depression, chronic medical conditions, and health risk behaviors. Results. Physical abuse, a direct ACE, and household member incarceration, an environmental ACE, was significantly associated with current depressive symptoms. Approximately 32.1% of Black men reported exposure to verbal abuse before age 18, the most prevalent direct ACE. In contrast, a larger proportion (48.6%) of Black men reported exposure to divorce before 18, the most prevalent environmental ACE. Physical abuse and stroke were statistically significant (OR = 4.14; 95% CI [1.69, 10.12]; p < 0.05). Approximately 9.2% of the Black men in the study reported experiencing five or more ACEs. Health risk behaviors did not mediate depression among Black men. Conclusion. Physical abuse and household member incarceration exert a significant impact on current depression. Indeed, verbal abuse and divorce demonstrated a significant relationship with a lifetime diagnosis of depression. The study findings have implications for health education practitioners, researchers, and policymakers interested in improving mental health through prevention and reducing childhood exposure to abuse.