# Association of Social Determinants of Health and Health Equity with Adverse Childhood Experiences in Georgia, USA

## TL;DR

This study explores how social factors like poverty and lack of support are linked to childhood trauma in Georgia, showing higher risks for vulnerable groups.

## Contribution

The study identifies specific social determinants strongly associated with adverse childhood experiences, emphasizing structural inequities.

## Key findings

- Lack of emotional support increases odds of witnessing parental violence and physical abuse.
- Sexual and gender minorities face higher odds of childhood sexual abuse.
- Transportation barriers are linked to increased odds of adverse childhood experiences.

## Abstract

Background/Objectives: Adverse childhood experiences (ACEs), including physical and sexual abuse, are significantly associated with long-term health issues, particularly among socially disadvantaged populations. The study examines the social determinants of health, such as poverty, racial inequities, and limited access to care, to assess their association with adverse childhood experiences, including exposure to physical violence and sexual abuse. Methods: We performed multivariable logistic regression analyses using data from the 2023 Georgia Behavioral Risk Factor Surveillance System (BRFSS) (n = 8227) to examine associations between selected ACEs and key social determinants of health (SDOH). Results: Our results indicated that a lack of emotional and social support was associated with increased odds of witnessing parental violence (AOR = 2.00) and physical abuse (AOR = 1.90). Absence of food insecurity was associated with lower odds of witnessing parental violence (AOR = 0.65), unwanted sexual touching (AOR = 0.77), and forced sex (AOR = 0.63). Similarly, not reporting transportation barriers was associated with lower odds across ACE outcomes (AORs ranging from 0.54 to 0.65). Sexual and gender minority individuals exhibited substantially higher odds of childhood sexual abuse (AORs = 3.64–5.56). Hispanic ethnicity was associated with increased odds of physical abuse (AOR = 1.47), and older adults (ages 45–64) had greater odds of experiencing forced sex (AORs = 2.08–2.48). These findings highlight complex relationships between SDOH and early trauma. Conclusions: Trauma-informed public health strategies must address structural inequities and strengthen emotional and material support for vulnerable populations.