Adverse Childhood and Family Experiences Among American Indian and Alaska Native Children in North Dakota: Analysis of 2011/12 National Survey of Children's Health Data

Background: A growing body of research demonstrates long-term health consequences of adverse childhood and family experiences (ACFEs) including greater comorbidity in adulthood. ACFEs among American Indian and Alaska Native (AIAN) children in North Dakota (ND) have not been well studied. Our study explores ACFEs among AIAN and white children in ND.

Methods: Data on parent-reported ACFEs for ND children 0-17 from the 2011/12 National Survey of Children’s Health were analyzed. AIAN responses were weighted according to the population distribution for the state.

Results: AIAN children in ND were significantly more likely than white children to have exposure to at least one ACFE (69% compared to 38%), and exposure increased with age (from 51% of AIAN children 0-9 to 88% of AIAN children 10-17). AIAN children were 6.6 times more likely than white children to have experienced four or more ACEs (25% compared to 4%). AIAN children were significantly more likely than white children to have experienced divorce/parental separation, living with someone with alcohol/drug problems, neighborhood violence, living with someone with mental illness, parental incarceration, and witnessing domestic violence.

Conclusions: Although ND is at the national average in terms of ACFEs prevalence, stark disparities exist between AIAN and white children in the state. Health professionals and policy makers need to focus ACFE prevention efforts on AIAN children to reduce the health disparities seen in this population and to reduce long-term costs associated with negative outcomes resulting from ACFE exposure.