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Primary Submission Category: Non-health institutions (business, political, education systems)
Examining the Gendered Relationship Between Adverse Childhood Experiences (ACES), Upward Mobility and Mental Health
Authors: Kimberly Narain, Rebecca Dudovitz, Nicholas Jackson, Mitchell Wong,
Presenting Author: Kimberly Narain*
Research Objective: To examine the relationship of upward mobility to mental health, across ACES and gender
Study Design: We analyzed data from a natural experiment of low-income students in Los Angeles who were offered entrance to high-performing charter high schools via a random lottery in 2013. We compared lottery winners to wait-listed students, reducing selection bias. Self-reported mental health (self-efficacy, hopelessness, depression, and stress across life domains (home, school, romantic, peers, money, balancing and future)) were collected using validated measures annually (9th-12th grade) and at age 20 years except for the stress measures which were not captured in the 12th grade. ACES were assessed at age 18-19 via a 10-item scale. ACE counts were dichotomized as high (>=4) vs. low-to-moderate (<4)). We conducted gender-stratified mixed effects models with person random intercept and clustered robust standard errors for school ID, with time, ACEs, high-performing school status, and their three-way interaction specified as fixed effects. Models controlled for individual and parental-level demographics. The p-value was <.05. We present our results comparing the change from baseline to 20 years old.
Population Studied: 944 (522 female and 422 male) primarily Hispanic students
Principle Findings: There was a significant three-way interaction such that males in low performing schools had higher stress (at home, romantic, and at school) when exposed to high vs. low ACEs and the effect of high ACEs on these outcomes increased over time, relative to those in high-performing schools. For females, the significant interaction indicated that high vs. low ACEs exposure worsened self-efficacy, which was amplified over time, for those in high-performing compared to low-performing schools.
Implications for Practice or Policy: High-performing schools lessened the impact of high ACEs on mental health among boys but not girls and we need to investigate why.