Social Safety and Health Outcomes in Emerging Adults: Interactions of Adverse Childhood Experiences and Discrimination

Social safety theory suggests that individuals from minoritized racial and ethnic groups or sexual and gender diverse (SGD) groups are exposed to multilevel and interacting stressors, which can set the stage for adverse health outcomes. Using a social safety framework, we examine interactions between discrimination and adverse childhood experiences (ACEs) on health outcomes and how these interactions may differ by race and ethnicity or SGD status among young adults. An online survey with 2287 young adults (mean age = 25.8 years; 55.5% female) assessed ACEs and interpersonal discrimination and sleep quality, problematic alcohol or cannabis use, and post-traumatic stress disorder (PTSD) symptoms. Linear regression analyses tested interactions between ACEs and discrimination in relation to the outcomes among the overall sample and stratified by race and ethnicity or SGD status. In the overall sample, there was one significant interaction between ACEs and discrimination, such that those experiencing both greater exposure to ACEs and greater discrimination reported higher PTSD scores. Race-stratified models showed that among people of color experiencing high levels of ACEs, greater discrimination was associated with greater PTSD scores. SGD-stratified models showed that for problematic alcohol use and PTSD there was a significant interaction between ACEs and discrimination only among non-SGD participants. Consistent with social safety theory, findings highlight the potential health consequences of experiencing both discrimination and childhood adverse experiences. Intervention efforts are needed to help young people increase coping skills and other strategies to promote resilience when experiencing major life stressors.