Abstract 4367009: Characterizing Conventional and Expanded Adverse Childhood Experiences’ Effect on Mental Health in Black Men with Unideal Cardiovascular Health: Black Impact

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Objective: Adverse Childhood Experiences (ACEs) are traumatic exposures such as abuse, neglect, and household challenges that occur in childhood, and are associated with numerous psychiatric and cardiovascular conditions in adulthood. An expanded list of ACEs accounting for community-level stressors like experiences of racism, witnessing violence, bullying, foster care, and living in unsafe neighborhoods, have also been associated with poor health outcomes decades later. Black men may face structural inequities that increase the risk of exposure to ACEs, while also facing disparities in both cardiovascular health (CVH) and mental health outcomes. Despite these disproportionate risks, research examining household, family and community-level ACEs remain understudied in Black men. Given the importance of mental wellbeing to cardiovascular health, understanding how childhood adversity affects mental health warrants more study, particularly in Black men with unideal cardiovascular health. Methods: 149 Black men with low or moderate cardiovascular health participating in a community-based lifestyle intervention study, Black Impact, were surveyed for conventional ACEs, expanded ACEs, and validated measures of depressive symptoms, perceived stress, and social/emotional well-being. Linear regression models examined how ACEs predicted mental health measures. Logistic regression models examined ACEs’ effect on the odds of reaching clinically significant depression. Results: Each additional ACE was significantly associated with greater depressive symptoms, perceived stress, and social isolation, as well as lower emotional wellbeing and social functioning. An ACE score ≥ 4 was associated with 459% increased odds of reaching clinically significant depression (OR 4.59, 95% CI: 1.62 – 12.95) compared to 0-3 ACEs. Family and household-level ACEs were associated with all mental health measures. Community-level ACEs were associated with depressive symptoms, perceived stress and emotional wellbeing, but they were not associated with social functioning and social isolation. Conclusion: Increased ACEs predicted worse mental health symptoms across all measures in a sample of Black men with low or moderate cardiovascular health. Next steps include assessing the relationship between ACEs exposure and lifestyle intervention outcomes and exploring how to interrupt ACE-health outcome pathways to mitigate mental health and CVH disparities among Black men.

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