Race, Ethnicity, Socioeconomic Status and Stressful Life Events during Childhood

Research Article

J Pediatr & Child Health Care. 2022; 7(1): 1053.

Income Gradient in Children’s Physical Activity: Diminished Returns in Black Families

Boyce S2, Assari S1*, Bazargan M1,3 and Caldwell CH4,5

1Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA

2Department of Pediatrics, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA

3Department of Family Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA

4Center for Research on Ethnicity, Culture, and Health (CRECH), School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA

5Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA

*Corresponding author: Shervin Assari, Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA

Received: January 14, 2022; Accepted: February 17, 2022; Published: February 24, 2022


Background: Children are exposed to a wide range of stressful life events (SLEs) in the family and the community. Exposure to stress in the community as well as the family may depend on socioeconomic status (SES) and race/ ethnicity. Currently, there is limited data that explores different types of SLEs experienced by racial and ethnic groups of children.

Aim: To compare the different types of SLEs experienced by a racially and ethnically diverse group of children, with a major emphasis on family and community context.

Methods: This cross-sectional study included 5066 adolescents 9-10 years of age from the Adolescent Brain Cognitive Development (ABCD) study. Race and ethnicity were the independent variables. The main outcomes were exposure to eight types of SLEs measured during an interview with the parent. Age and gender were the confounders. Parental marital status, parental education, parental employment, financial difficulties, and neighborhood income were the mediators. Logistic regression was used to analyze the data.

Results: In the absence of SES in the model, Black but not Latino children experienced higher levels of SLEs in some but not all domains. SES explained some of the effects of race on SLEs, however, race remained significant in some domains, when the effects of SES indicators were controlled. While we found the same pattern for family and neighborhood SLEs, the observations showed some degrees of heterogeneities based on the specific type of SLE. There were also domains of SLEs that did not correlate with race. However, all types of SLEs were associated with SES.

Conclusions: Our study showed that Black race, but not Latino ethnicity, is associated with disproportionately higher levels of experiencing family and neighborhood SLEs. The effects of race on some but not all types of SLEs are due to the racial gap in SES. Racial health quality requires the elimination of racial inequalities in exposure to stressful life events.

Keywords: Race; Ethnicity; Stress; Family; Neighborhood


Stressful life events (SLEs) occur in various domains and settings including neighborhood and family [1-4]. One common type of SLE is exposure to violence, which may occur in the community or family [5]. Given the high prevalence, childhood exposure to SLEs is a public health concern in the United States [5]

Some research has shown that SLEs are predictive of poor outcomes regardless of their domains and settings [6,7]. Some other research suggests that SLEs that occur in the family may be more detrimental because family is more proximal to children, suggesting that exposure to family based SLEs may be more repeated and chronic [8,9]. It is important to note, however, that both neighborhood- and family-related SLEs have been found to be higher in children from minority (racial and ethnic) backgrounds and low socioeconomic status (SES) backgrounds [10].

In 2009, among children ages 12-17 years, over 70% of which were Black, Hispanic or came from low-income households, more than half of them had been victims of assault and one third either witnessed the victimization of another person or were exposed indirectly to victimization, such as through knowing someone close who had been murdered even if they had not directly witnessed the murder [5,11]. Children in urban environments have exposure to high levels of community violence with 80% reporting that they witnessed community violence and 70% reporting being victims of violence [5,12]. In particular, Black adolescents are at greatest risk compared to other racial/ethnic adolescents such as Latinos regarding exposure to community violence [13,14]. Of note, chronic exposure to community violence has been closely linked to posttraumatic stress disorder (PTSD) in children as well as other mental health problems such as anxiety and depression [12].

Community SLEs are also linked to Major Depressive Disorder [15], obesity [16,17], and increased mortality for Black children [18]. Black children who perceive their communities as unsafe developed symptoms of major depressive disorder at higher rates [15]. This risk may be due to the economic and social challenges uniquely faced by this group including being educated in schools with limited resources, differential pay, unemployment, limited employment opportunities, and police brutality that persist from childhood to adulthood [15]. Furthermore, perceived community violence has been shown to increase all-cause mortality for Blacks compared to Whites [18]. Community SLEs may differently affect the health of Black children [18].

Urban communities, that continues to have a high Black population, lack economic and social resources and are highly predisposed to disorder, both physical and social, made worse by low levels of informal social control [2]. Additionally, there tend to be low trust levels by individuals in the community, resulting in limited creation of local networks that may collaborate against crime and disorder [2]. This creates stress on individuals in the community who may also perceive the neighborhood to be dangerous leading to increased psychological distress [2]. Furthermore, Black children experience racial discrimination not just at individual/interpersonal levels but at societal (neighborhood) and institutional levels as well [19]. This is even more prevalent in the current society with children being exposed to acts of discrimination through videos of race-based violence, such as the numerous acts of police brutality occurring against members of the children’s racial community [20]. The frequency of watching such acts creates significant psychological distress particularly as children develop and transition into adulthood. Beyond the visuals on social media of race-based violence, are the harmful forms of physical violence that Black adolescents and adults experience such as physical fights with injuries, aggravated assault and homicide, the actual experience of police brutality and the harmful transgenerational effects on Blacks [21-23].

Family SLEs, due in large part to poverty, causes parental strain, increased family dysfunction, and an environment where children in the household are exposed to adverse events [24]. Exposure to violence and other childhood traumas are a major concern in children given what is known in the literature about the impact of SLEs in childhood. SLEs in childhood also known as adverse childhood events (ACEs) include being a victim of abuse (physical, emotional, and sexual abuse); experiencing neglect (physical and emotional); witnessing domestic violence within the household; experiencing parental separation or divorce; and having family members affected by mental illness, substance abuse and who have been/or are incarcerated [25]. The medical impacts on children exposed to SLEs include increased risk of respiratory, heart, and metabolic diseases, anxiety, as well as substance use [26-28], drug use [29], PTSD [30], depression, suicide [31,32] and mortality [31-36]. In a recent study that looked at the impact of family income and parental educational attainment on childhood trauma exposure for non-Hispanic Black compared to non-Hispanic Whites, it was found that non-Hispanic Black children experience higher than expected exposures to SLEs [37].

For low SES individuals and racial and ethnic minorities, family operates both as a source of support, as well as the cause of SLEs. As shown by the Family Stress Model [38], higher perceived parental stressful events were associated with worse psychological adjustment for Black children. Mcloyd (1998, 1990) has done extensive empirical and theoretical work on family stressful event processes for economically disadvantaged families and suggests that exposure to poverty associated stressful events function similarly across race/ ethnic groups [24]. This is in part because both low SES individuals and racial and ethnic minorities face large degrees of SLEs such as economic stress [24]. Interestingly, despite the significant positive effect of family support, when the combined effects of support and stressful events are tested, it is the negative effect of family stressful events, not the positive effect of family support that stays consistent with the family stress model [39-42]. This supports observations by Bauermesiter et al., in 2001, that bad (stressful events) is stronger than good (support) [39].

Contributory to the high violence exposure risk in Black children are SES, community context, and SLEs. Among various SES indicators, family income has been shown to be one of the most influential social determinants of children’s development, behaviors, and health [43-46]. High-income parents report greater parental involvement, which has positive outcomes across several domains of childhood development [47-50]. However, recent literature has shown that compared to Whites, Black children are experiencing poorer outcomes in various domains such as school performance [51], Body Mass Index [52], chronic disease, tobacco use [51], alcohol use, and aggression [14], across all SES levels.

It will be important to determine the different types of SLEs experienced by children across different domains and racial, ethnic, and SES groups. Currently, there is limited data that explores this topic, and more attention needs to be given to explore and elucidate this area.


To compare different types of SLEs experienced by racially, ethnically, and socioeconomically diverse groups of children across different domains including family and neighborhood domains.


Design and settings

This was a cross-sectional, secondary analysis of the Adolescent Brain Cognitive Development (ABCD) study [53-57]. The ABCD study is the largest, national study of brain development in children. The ABCD data set provides several advantages including (a) publicly available data set (b) national sample, (c) large sample size, (d) large sample of blacks, and (e) substantial behavioral and variables. Please see references for further information about ABCD’s purpose, methodology, and measurement [53,58].

Participants and sampling

Selection of participants of the ABCD study occurred across multiple cities and 15 different states in the US. Recruitment of the sample was mostly through school systems. The recruitment catchment area of the ABCD study, which composed of 21 participating locations, encompassed more than 20% of the United States populace 9-10-years of age. The ABCD study applied a carefully designed sampling and recruitment process across various sites [53,58], to ensure that the sample is random and representative. Such efforts of local randomization yielded a final overall ABCD sample that is a close approximation of the US national sociodemographic factors. These sociodemographic factors include race and ethnicity, age, gender, SES, and urbanicity. The SES target in the ABCD has two sources: 1) the American Community Survey (ACS) and 2) annual 3rd and 4th-grade school enrollment. A detailed description of the ABCD sample and sampling are available here [59]. The first data are from an annual survey by the U.S Census Bureau completed by approximately 3.5 million households. The second data are kept by the National Center for Education Statistics (NCES) in affiliation with the US Department of Education.

Study variables

The study variables included demographic factors, SES indicators, neighborhood factors, and life stressors.


Stressful life events: Parents were interviewed on the subject of the eight types of SLE experienced by their child. SLEs were measured using the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) [56-58]. The K-SADS is a semi-structured interview aimed at early identification of high-risk children. The items are shown in Table 1. The responses for each item were coded as 0 (no) or 1 (yes).