Social Stratification of ACE Biomarkers

Adverse childhood experiences (ACEs) are early-life deviations from expected environments that contribute to adverse health, social, and behavioral outcomes. Fundamental cause theory and Marxist theory link these outcomes to structural inequality, while life course theory and cumulative disadvantage theory highlight compounded long-term disparities. Bronfenbrenner’s ecological systems theory integrates these perspectives across multiple levels and their interactionary relationships. Using 2021-2023 NHANES data, we grouped ACE proxies into SES and health categories to measure influence on biology. To assess the biological impact, we examined 5-methyltetrahydrofolate, a key factor in DNA methylation, a process inhibited by early-life adversity. After exploring a binary variable, we conducted an ordinal logistic regression, comparing critically low (1-9 nmol/L), severely low (10-19 nmol/L), moderately low (20-29 nmol/L), marginally low (30-39 nmol/L), and normal (40 nmol/L and above), suggesting robustness. The strongest predictors were long-term measures - education and wealth. Effects were nonlinear, with disparities widening at the tails, where low SES and poor health had a multiplicative effect. Future research will explore additional ACE proxies and biomarkers. Findings enhance our understanding of health disparities, support policy reforms, and could influence medical education, public health, and healthcare costs. Addressing ACEs earlier may foster a healthier, more equitable society

Disadvantage · Health equity · Inequality · Life course approach · Public health · Social determinants of health · Social inequality · Social theory · Child Abuse and Trauma · Epigenetics and DNA Methylation · Folate and B Vitamins Research