Firearm Violence Exposure and Functional Disability among Black Men and Women in the United States.

This study investigates the relationship between firearm violence exposure and functional health among Black adults in the United States (US). We examined associations between different forms of firearm violence exposure (direct, indirect, and community) and functional health with particular attention to differences across sex groups. We used survey data from a nationally representative sample of 3015 Black adult Americans to analyze associations between types of firearm violence exposure and four aspects of functional disability including: the ability to concentrate, walk/use stairs, dress/bathe, and run errands among males and females. The findings indicate notable disparities in exposure and health outcomes based on the exposure type and cumulative exposure to violence. Among males, functional disability was associated most closely with community violence exposure, while direct threats of firearm violence were most consequential for functional health among females. High cumulative exposure to firearm violence was linked to significant risks to functional health, particularly among females. The results shed light on sex differences in the repercussions of firearm violence exposure and emphasize its implications for daily functioning and health. This study contributes to the understanding of the multifaceted impacts of firearm violence on functional well-being and highlights the need for inclusive and culturally sensitive healing approaches based in community settings. There is a critical need for heightened awareness and strategies to enhance the well-being of those disproportionately affected by firearm violence in the US.

Regional differences in firearm ownership, storage and use: results from a representative survey of five US states.

BACKGROUND: Firearm access and storage practices influence risk for injury and death; however, prior research has considered only national and regional differences on these variables, overlooking state-level differences. OBJECTIVES: To analyse and describe statewide differences in firearm ownership, storage and use in a representative sample of five US states. DESIGN: Variables were assessed via an online self-report survey administered between 29 April 2022 and 15 May 2022. SETTING: Surveys were completed online. PARTICIPANTS: Participants (n=3510) were members of knowledge panel, a probability-based sample recruited to be representative of US adults. All participants were aged 18+ and resided in one of five states: Colorado, Minnesota, Mississippi, New Jersey or Texas. MEASUREMENTS: We used χ2 tests to examine state differences in firearm ownership, childhood firearm experiences and purchasing. A series of analyses of covariance were then used to assess differences in firearm storage, firearms owned and carrying behaviours while adjusting for pertinent demographic characteristics. RESULTS: We found significant differences in firearm ownership across states. There were significantly more first-time firearm purchasers during the firearm purchasing surge in New Jersey. Both Mississippi and Texas have elevated rates of unsecure storage practices and firearm carrying outside of the home. LIMITATIONS: Results are cross-sectional and self-report. Findings may not generalise beyond the five states assessed in this survey. CONCLUSIONS: Public health messaging around firearm safety should account for differences in key firearm behaviours related to ownership, storage and use to ensure effective communication and reduce the risk of gun injury and death across states.

Police Contact, Non-Suicidal Self-Injury, and Suicidal Ideation: Findings From a National Sample of Canadian Adolescents and Young Adults.

BACKGROUND AND OBJECTIVES: The purpose of this research is to investigate associations between police contact, non-suicidal self-injury (NSSI), and suicidal ideation (SI) among a national sample of Canadian adolescents and young adults (ages 16-30). METHODS: Data used in this study were obtained from the Canadian Study of Adolescent Health Behaviors (N = 940), a national survey of Canadians ages 16-30. RESULTS: Police contact was associated with higher odds of NSSI (OR = 1.98, 95% CI = 1.37, 2.86). Those who reported police contact with intrusion (OR = 2.39, 95% CI = 1.49, 3.38) and police contact with harassment (OR = 3.98, 95% CI = 2.30, 6.88) had higher odds of NSSI relative to respondents with no contact. Finally, any police contact was associated with higher odds of SI (OR = 1.56, 95% CI = 1.04, 2.34) and respondents experiencing police stops with harassment had higher odds of SI compared to those who had never been stopped (OR = 2.48, 95% CI = 1.45, 4.24). CONCLUSIONS: Distressing police contact heightens the risk of NSSI and SI among young people. Rigorous evaluation of trauma-informed, developmentally appropriate strategies for identifying and intervening on NSSI and SI following adverse police encounters should be prioritized.

Reciprocal Neighborhood Dynamics in Gun Violence Exposure, Community Health, and Concentrated Disadvantage in One Hundred US Cities.

Gun violence imparts a tremendous human and financial toll on local communities. Researchers have documented extensive mental and physical health consequences of generalized violence exposure but few studies have analyzed the particular impacts of gun violence on community well-being using nationally comprehensive data. We leverage a unique database of almost 16,000 neighborhoods in 100 US cities (2014-2019) to examine how year-over-year rates of gun violence correspond to overall neighborhood well-being and three aspects of community health: (1) health behaviors, (2) physical and mental health status, and (3) health prevention efforts. We simultaneously consider the reciprocal influence of neighborhood well-being on subsequent gun violence while accounting for concentrated disadvantage in communities. The results demonstrate that gun violence is associated with poorer community health in subsequent years, particularly health behaviors and mental/physical health status. Furthermore, we find substantial reciprocal effects for both gun violence and community health in their relationship to neighborhood concentrated disadvantage. These findings highlight the consequential role of gun violence in perpetuating cycles of harm in local communities.

Youth Mental Well-Being Following Witnessed Police Stops.

The purpose of the present study is to investigate mental well-being among youth after witnessing police stops. A national, urban-born sample of youth in the USA from the most recent wave (2014-2017) of the Fragile Families and Child Wellbeing Study (FFCWS) was employed, with a focus on youth who had not been directly stopped by police (N = 2506). We used t-tests and multivariable ordinary least squares (OLS) regression to estimate direct associations, product-term analysis to test for effect modification by gender and race/ethnicity, and the Karlson-Holm-Breen (KHB) method to assess for mediation by experiences of emotional distress during a stop. Findings indicate that youth who have witnessed police stops report significantly higher levels of depression (t = 5.93, p < 0.01) and anxiety (t = 6.57, p < 0.01) and lower levels of happiness (t = - 4.02, p < 0.01) following the stop than those who have not. Among youth witnessing stops (N = 1488), more intrusive witnessed encounters correspond to diminished mental well-being across indicators, in part due to elevated emotional distress during witnessed stops. Findings hold regardless of gender, yet vary somewhat by race and ethnicity, with youth of color reporting less anxiety than their White counterparts after witnessing an intrusive stop, but reporting greater reductions in happiness. Collectively, our findings suggest that witnessing police stops may contribute to inequities in youth mental well-being. A public health approach that combines prevention and treatment strategies may mitigate the harms of police exposure and reduce disparities in youth well-being.

Silence After Stops? Assessing Youth Disclosure of Police Encounters.

Youth-police encounters are common in the United States, with potentially serious mental health ramifications requiring social supports to cope. Still, no research has examined youth disclosure of these experiences to others. Using a national sample of youth stopped by police (N = 918; 56.09% Black, 20.48% Hispanic), we find that more than two-thirds disclosed police encounters-most commonly to mothers. Even so, disclosure became less likely as perceptions of procedural injustice, social stigma, and legal cynicism increased. Among youth who disclosed stops but not to parents, disclosure to friends was common (61.18%), whereas disclosure to nonparent adults was not. Enhanced training for teachers, school counselors, and community leaders may improve youth outcomes by facilitating additional opportunities for disclosure and support.

Sleep duration, depressive symptoms, and digital self-harm among adolescents.

BACKGROUND: This study examines the relationship between sleep duration, depression, and engagement in a novel cyber behavior, digital self-harm, among adolescents. METHOD: Logistic regression analyses were conducted using cross-sectional data from the 2019 Florida Youth Substance Abuse Survey (N = 9,819; 48% male; avg. grade level = 9th grade [SD = 1.9]) to analyze the association between sleep duration and digital self-harm. A Karlson-Holm-Breen (KHB) analysis was used to assess whether depressive symptoms attenuate this association. RESULTS: Bivariate results indicated that longer sleep duration was associated with lower incidence of digital self-harm. Multivariate results showed that sleep duration was inversely associated with engaging in digital self-harm, net of all covariates. Depressive symptoms attenuated the influence of sleep duration on digital self-harm by 50.72%. CONCLUSIONS: Both insufficient sleep and depressive symptoms were associated with engagement in digital self-harm among adolescents. Prospective research is needed, however, to confirm this pathway. Practitioners and clinicians should consider discussing digital self-harm with adolescents and parents, especially if adolescents are experiencing poor sleep and depressive symptoms.

Household food insecurity and school readiness among preschool-aged children in the USA.

OBJECTIVE: The present study examines the association between mild and moderate-to-severe household food insecurity and school readiness among a nationally representative sample of preschool-aged children. DESIGN: Cross-sectional data pertaining to household food availability as well as four domains of school readiness - early learning skills, self-regulation, social-emotional development and physical health & motor development - were employed. SETTING: The USA. PARTICIPANTS: 15 402 children aged 3-5 years from the 2016-2018 National Survey of Children's Health. RESULTS: Both mild and moderate-to-severe food insecurity are associated with an increase in needing support or being at-risk in each of the four school readiness domains, particularly Self-Regulation (IRR = 4·31; CI 2·68, 6·95) and Social-Emotional Development (IRR = 3·43; CI 2·16, 5·45). Furthermore, while nearly half of the children in food-secure households are on-track across all four school readiness domains (47·49 %), only one in four children experiencing moderate-to-severe household food insecurity is on-track across all domains (25·26 %). CONCLUSIONS: Household food insecurity is associated with reductions in school readiness among preschool-aged children.

Food deserts and cardiovascular health among young adults.

OBJECTIVE: This study assesses the association between living in a food desert and cardiovascular health risk among young adults in the USA, as well as evaluates whether personal and area socioeconomic status moderates this relationship. DESIGN: A cross-sectional analysis was performed using data from Wave I (1993-1994) and Wave IV (2008) from the National Longitudinal Study of Adolescent to Adult Health. Ordinary least squares regression models assessing the association between living in a food desert and cardiovascular health were performed. Mediation and moderation analyses assessed the degree to which this association was conditioned by area and personal socioeconomic status. SETTING: Sample of respondents living in urban census tracts in the USA in 2008. PARTICIPANTS: Young adults (n 8896) aged 24-34 years. RESULTS: Net of covariates living in a food desert had a statistically significant association with cardiovascular health risk (range 0-14) (ß = 0·048, P < 0·01). This association was partially mediated by area and personal socioeconomic status. Further analyses demonstrate that the adverse association between living in a food desert and cardiovascular health is concentrated among low socioeconomic status respondents. CONCLUSIONS: The findings from this study suggest a complex interplay between food deserts and economic conditions for the cardiovascular health of young adults. Developing interventions that aim to improve health behaviour among lower-income populations may yield benefits for preventing the development of cardiovascular health problems.

Non-fatal gun violence and community health behaviors: A neighborhood analysis in Philadelphia.

Research shows that community violence is associated with an array of negative health outcomes, yet no study has examined the specific association between different types of gun violence and collective health behaviors in local neighborhoods. Using data from neighborhoods in the city of Philadelphia, this study examines the association between total, fatal, and non-fatal gun violence and measures of physical inactivity, obesity, sleep, and smoking. We find the rate of non-fatal shootings is associated with a composite measure of health behaviors, net of all neighborhood-level covariates and general community violence. Ancillary analyses show that non-fatal shootings are particularly associated with physical inactivity and obesity. Notably, fatal shootings are not associated with any behavioral health measure after accounting for nonlethal shootings. The results support improved data collection efforts to measure non-fatal shootings across the U.S. and greater attention to the collective health consequences of gun violence in local communities.

Physical Intimate Partner Violence and Emotional Harm in Five U.S. States.

The purpose of this study was to assess the relationship between physical intimate partner violence (IPV) victimization and four related aspects of emotional well-being: threat sensitivity, intolerance of uncertainty, impulse control, and access to resources for emotional regulation. We draw on a transactional model of IPV and emotional regulation to theorize how invalidation and partner threats in relationships can generate harmful emotional outcomes. We used representative data collected for residents living in five U.S. states: Colorado, Minnesota, Mississippi, New Jersey, and Texas. Our analytic sample included individuals who reported having been in a romantic relationship in the past year (N = 2,501). Data were collected using a probability-based web panel, between April 29 and May 15, 2022. Following the presentation of descriptive statistics and bivariate correlations, we developed a series of four multivariate models (ordinary least squares [OLS], negative binomial) to analyze the association between IPV victimization and each emotional outcome. All models adjusted for pertinent demographic and geographic control measures. Physical IPV victimization was associated with increased intolerance of uncertainty and heightened threat sensitivity. IPV victimization also corresponded with poorer impulse control and fewer resources for emotional regulation. Overall, our results demonstrate that experiences of physical IPV victimization are linked to poorer emotional outcomes. These outcomes can be harmful to broader mental health and potentially impact long-term well-being. The findings underscore the importance of mental health screenings that extend beyond assessments of diagnostic-level functions and allocating resources toward alleviating other clinically relevant factors that might arise from or even prompt additional exposure to physical IPV.

Youth Incarceration in Adult Facilities and Mental Health in Early Adulthood.

PURPOSE: To examine the relationship between youth incarceration in adult correctional facilities and mental health in early adulthood. METHODS: We analyzed nationally representative data from 1997 through 2019 (N = 8,961) using the National Longitudinal Survey of Youth 1997. An ordinary least squares regression model using inverse probability weights was used to assess the influence of youth incarceration in an adult facility on average mental health scores from age 18 to 37. RESULTS: Respondents incarcerated in an adult facility as a youth had poorer average mental health than those not held in adult prisons or jails over the course of the study period. Those incarcerated for longer in adult facilities also exhibited more mental health symptoms. DISCUSSION: Young people incarcerated in adult correctional facilities experience poorer long-term mental health related to depression and anxiety in early adulthood.

Gun Violence Exposure and Suicide Among Black Adults.

Importance: Black individuals are disproportionately exposed to gun violence in the US. Suicide rates among Black US individuals have increased in recent years. Objective: To evaluate whether gun violence exposures (GVEs) are associated with suicidal ideation and behaviors among Black adults. Design, Setting, and Participants: This cross-sectional study used survey data collected from a nationally representative sample of self-identified Black or African American (hereafter, Black) adults in the US from April 12, 2023, through May 4, 2023. Exposures: Ever being shot, being threatened with a gun, knowing someone who has been shot, and witnessing or hearing about a shooting. Main Outcomes and Measures: Outcome variables were derived from the Self-Injurious Thoughts and Behaviors Interview, including suicidal ideation, suicide attempt preparation, and suicide attempt. A subsample of those exhibiting suicidal ideation was used to assess for suicidal behaviors. Results: The study sample included 3015 Black adults (1646 [55%] female; mean [SD] age, 46.34 [0.44] years [range, 18-94 years]). Most respondents were exposed to at least 1 type of gun violence (1693 [56%]), and 300 (12%) were exposed to at least 3 types of gun violence. Being threatened with a gun (odds ratio [OR], 1.44; 95% CI, 1.01-2.05) or knowing someone who has been shot (OR, 1.44; 95% CI, 1.05-1.97) was associated with reporting lifetime suicidal ideation. Being shot was associated with reporting ever planning a suicide (OR, 3.73; 95% CI, 1.10-12.64). Being threatened (OR, 2.41; 95% CI, 2.41-5.09) or knowing someone who has been shot (OR, 2.86; 95% CI, 1.42-5.74) was associated with reporting lifetime suicide attempts. Cumulative GVE was associated with reporting lifetime suicidal ideation (1 type: OR, 1.69 [95% CI, 1.19-2.39]; 2 types: OR, 1.69 [95% CI, 1.17-2.44]; ≥3 types: OR, 2.27 [95% CI, 1.48-3.48]), suicide attempt preparation (≥3 types; OR, 2.37; 95% CI, 2.37-5.63), and attempting suicide (2 types: OR, 4.78 [95% CI, 1.80-12.71]; ≥3 types: OR, 4.01 [95% CI, 1.41-11.44]). Conclusions and Relevance: In this cross-sectional study, GVE among Black adults in the US was significantly associated with lifetime suicidal ideation and behavior. Public health efforts to substantially reduce interpersonal gun violence may yield additional benefits by decreasing suicide among Black individuals in the US.

Local gun violence, mental health, and sleep: A neighborhood analysis in one hundred US Cities.

RATIONALE: Community gun violence significantly shapes public health and collective well-being. Understanding how gun violence is associated with community health outcomes like mental health and sleep is crucial for developing interventions to mitigate disparities exacerbated by violence exposure. OBJECTIVE: This study examines the associations between community gun violence , insufficient sleep, and poor mental health across neighborhoods in the United States. METHODS: We utilized a novel database covering nearly 16,000 neighborhoods in 100 US cities from 2014 through 2019. Correlated trait fixed-effects models were employed to conduct all analyses while considering various neighborhood covariates such as concentrated disadvantage, demographic composition, population density, and proximity to trauma centers. RESULTS: Our analysis revealed that greater gun violence is associated with both insufficient sleep and poor mental health in subsequent years. There is a reciprocal relationship between poor mental health and insufficient sleep, with each partially mediating the other's association with community gun violence. Notably, gun violence exhibits the strongest direct association with poor sleep rather than with poor mental health. We found a consistent reciprocal relationship between sleep and mental health at the community level. CONCLUSIONS: The findings highlight a complex interplay between community violence, sleep, and mental health, underlining the importance of reducing community violence through numerous long-term interventions to address health disparities across the US.

Individual and cumulative firearm violence exposure: Implications for sleep among Black and American Indian/Alaska Native adults.

PURPOSE: We investigated the relationship between various forms of firearm violence exposure and sleep problems among nationally representative samples of Black (N = 3015) and American Indian and Alaska Native (AI/AN) (N = 527) adults, focusing on difficulties falling asleep, staying asleep, and waking too early. Survey data were collected in April and May 2023. METHODS: We employed negative binomial regression models to analyze the associations between the different types of firearm violence exposure and sleep problems. We further examined associations between cumulative firearm violence exposure and sleep outcomes. RESULTS: A substantial proportion of Black (59%) and AI/AN (56%) adults reported experiencing some form of firearm violence exposure. Being threatened with a firearm emerged as a consistent factor associated with sleep problems for both racial groups. Witnessing or hearing about shootings was linked to sleep problems in the Black sample, while cumulative firearm violence exposure was associated with all sleep problems in both groups. CONCLUSIONS: Individual and cumulative firearm violence exposure is associated with increased sleep problems among Black and AI/AN adults.

Historical Redlining and Contemporary Violent Victimization Over the Life Course.

INTRODUCTION: This study assesses the relationship between living in historically redlined communities and the incidence of violent victimization and examines differences in this relationship across race and ethnicity. METHODS: Data are from the US National Longitudinal Study of Adolescent to Adult Health (Add Health) from Waves I (1994-1995; ages 12-17), III (2001; ages 18-26), IV (2008-2009; ages 24-32), and V (2016-2018; ages 34-44). Multi-level, within-between regression models were used to assess the relationship between residence in historically redlined areas and violent victimization from adolescence to adulthood. The study includes 8,266 participants, and data analysis was conducted in 2024. RESULTS: Respondents who lived in redlined areas throughout adolescence and adulthood reported a 4.8% higher average probability of violent victimization relative to those who never lived in redlined areas. Respondents who moved from a non-redlined to a redlined area across waves also reported a 2.2% higher probability of victimization, on average. Although Black and Hispanic respondents were significantly more likely than their White peers to live in a redlined area and report violent victimization at each stage of the life course, the probability of experiencing victimization while living in a redlined area was similar between racial and ethnic groups. CONCLUSIONS: These findings underscore the profound and enduring consequences of New Deal-era redlining policies for present-day safety, emphasizing the urgent need to confront and rectify historical injustices to enhance contemporary safety and well-being.

Incarceration of Youths in an Adult Correctional Facility and Risk of Premature Death.

Importance: Youths incarcerated in adult correctional facilities are exposed to a variety of adverse circumstances that could diminish psychological and physical health, potentially leading to early mortality. Objective: To evaluate whether being incarcerated in an adult correctional facility as a youth was associated with mortality between 18 and 39 years of age. Design, Setting, and Participants: This cohort study relied on longitudinal data collected from 1997 to 2019 as part of the National Longitudinal Survey of Youth-1997, a nationally representative sample of 8984 individuals born in the United States between January 1, 1980, and December 1, 1984. The data analyzed for the current study were derived from annual interviews between 1997 and 2011 and interviews every other year from 2013 to 2019 (19 interviews in total). Participants were limited to respondents aged 17 years or younger during the 1997 interview and alive during their 18th birthday (8951 individuals; >99% of the original sample). Statistical analysis was performed from November 2022 to May 2023. Intervention: Incarceration in an adult correctional facility before the age of 18 years compared with being arrested before the age of 18 years or never arrested or incarcerated before the age of 18 years. Main Outcomes and Measures: The main outcome for the study was age at mortality between 18 and 39 years of age. Results: The sample of 8951 individuals included 4582 male participants (51%), 61 American Indian or Alaska Native participants (1%), 157 Asian participants (2%), 2438 Black participants (27%), 1895 Hispanic participants (21%), 1065 participants of other race (12%), and 5233 White participants (59%). A total of 225 participants (3%) died during the study period, with a mean (SD) age at death of 27.7 (5.9) years. Incarceration in an adult correctional facility before the age of 18 years was associated with an increased risk of earlier mortality between 18 and 39 years of age compared with individuals who were never arrested or incarcerated before the age of 18 years (time ratio, 0.67; 95% CI, 0.47-0.95). Being arrested before the age of 18 years was associated with an increased risk of earlier mortality between 18 and 39 years of age when compared with individuals who were never arrested or incarcerated before the age of 18 years (time ratio, 0.82; 95% CI, 0.73-0.93). Conclusions and Relevance: In this cohort study of 8951 youths, the survival model suggested that being incarcerated in an adult correctional facility may be associated with an increased risk of early mortality between 18 and 39 years of age.

Firearm availability and police shootings of citizens: a city level analysis of fatal and injurious shootings in California and Florida.

BACKGROUND: A growing body of research has found a link between firearm availability and police shootings of citizens across place. The problem, however, is that the previous studies on the topic tend to suffer from several limitations: a near exclusive focus on citizen fatalities, units of analysis at the state or county levels, and a variety of proxy measures tapping into community-level firearm access. The current study set out to address these issues by examining the relationship between different forms of firearm availability and both fatal and nonfatal injurious police shootings of citizens at the city level. METHODS: More specifically, it merged The Trace's "Missing Pieces" measures of guns reported lost and stolen to police as well as licensed firearms dealers across jurisdictions from the Bureau of Alcohol, Tobacco, Firearms, and Explosives as proxies for firearm availability with data on police shootings of citizens in California and Florida from California's URSUS system and the Tampa Bay Times' "Why Cops Shoot" database, respectively. Negative binomial regression analyses were performed on a sample of 253 cities across the two states and a sub-sample of cities with licensed firearms dealers. RESULTS: Findings uncovered a small positive association between rates of federally licensed guns stores and the number citizens shot by police as well as police shooting incidents while controlling for several community-level measures (e.g., concentrated disadvantage, gun homicide rates). Rates of guns lost or reported stolen were generally not significantly associated with the outcome measures in the multivariate models. CONCLUSIONS: Firearm availability is a significant correlate of police shootings. Pooled counts of both citizens shot by police and police shooting incidents are heightened in jurisdictions with higher rates of licensed gun dealers, which may be due to the fact that all firearms sold in the USA first make their way to the public through these mechanisms. Such licensed gun dealers must be appropriately monitored and audited to reduce illicit behavior and prevent firearms from making their way into secondary markets. Addressing access to firearms can be meaningful for a host of gun-related morbidity and mortality outcomes, including police shootings of citizens.

Firearm violence exposure and health in 2 national samples of Black and American Indian/Alaska Native adults.

Exposure to firearm violence is widespread and disproportionately experienced by communities of color, with implications for broad health disparities. Survey data were collected from 2 nationally representative samples of Black (n = 3015) and American Indian/Alaska Native (AI/AN) (n = 527) adults in the United States in April and May 2023. The exposure measures were 4 types of firearm violence exposure. The outcome measures were self-rated health, number of poor physical health days, and number of poor mental health days. Regression results demonstrate that being threatened with a firearm and hearing about or witnessing a shooting were associated with poorer self-rated, mental, and physical health across both samples. Cumulative exposure to firearm violence was particularly associated with increasing harms to health for all outcomes. In general, individual and cumulative firearm violence exposures are linked to poorer health among Black and AI/AN adults in the United States. Significant enhancements and long-term investment are needed for firearm violence prevention to yield improvements to population health, particularly among communities burdened with high levels of exposure to firearm violence.

Adverse Childhood Experiences and Adolescent Delinquency: A Theoretically Informed Investigation of Mediators during Middle Childhood.

OBJECTIVE: The purposes of this study are twofold. First, we explore the associations between cumulative ACEs at ages 5 and 7 and delinquency at age 14 in a national sample of youth in the United Kingdom (UK). Second, we explore the role of five theoretically relevant mediators in explaining this relationship. METHODS: Analyses were based on data from the UK Millennium Cohort Study-a prospective, longitudinal birth-cohort study of more than 18,000 individuals in the United Kingdom. RESULTS: The results indicate that early ACEs are significantly associated with adolescent delinquency, with effects becoming significantly larger as ACEs accumulate. Findings also reveal that child property delinquency, substance use, low self-control, unstructured socializing, and parent-child attachment at age 11 all significantly mediate the relationship between early ACEs and delinquency in adolescence, with early delinquency and low self-control emerging as the most robust mediators. CONCLUSIONS: Findings point to a need for early ACEs screening and a Trauma-Informed Health Care (TIC) approach in early delinquency prevention efforts. Early intervention efforts that bolster child self-control and curtail early-onset problem behaviors may also disrupt pathways from ACEs to adolescent delinquency.