Racial/Ethnic Differences in Adverse Childhood Experiences and Health-Related Outcomes: A Scoping Review

Racial and ethnic differences have been observed across patterns of substance use and exposure to adverse childhood experiences (ACEs). The goal of this review was to summarize the current evidence on ACE and health outcomes across racial and ethnic groups in the United States. A scoping review of the literature following the Preferred Reporting Items for Systematic Reviews and Meta- Analysis for Scoping Review (PRISMA-ScR) guideline was performed. Using predetermined search terms and parameters, an electronic database search of peer-reviewed literature between 1997 and 2022 was performed. Forty-five articles met the inclusion and exclusion criteria. Thirteen articles focused on health behavior and education outcomes, fifteen reported on physical health outcomes, and eighteen reported on mental health outcomes. Relatively to mental health outcomes, race/ethnicity appeared to play a less significant role in the relationship between ACE and behavioral outcomes or physical health outcomes. There was stronger evidence that race/ethnicity may moderate relationships between ACE exposure and mental health outcomes. Across health behavior, physical health, and mental health domains, the evidence suggests that the relationship between ACE exposure and health outcomes is not uniform across different racial and ethnic groups. These findings highlight the need for future research to uncover how cultural, societal, and developmental factors interact to shape health in the context following exposure to childhood adversity.