Skip to main content

Advertisement

SpringerLink
Log in

Community Adversity and Children’s Mental Health: Moderating Effects of Caregiver Service Utilization and Race on Children’s Internalizing and Externalizing Problems

  • Published:
Child and Adolescent Social Work Journal Aims and scope Submit manuscript

Abstract

This study examined the relationship between community adversity and childhood internalizing and externalizing problems, and whether this relationship is moderated by service utilization and race. The study involved 3225 children ages 2–17, and their caregivers, who participated in the second cohort of the National Survey on Child and Adolescent Well-Being. Bivariate correlation and regression analysis indicate that childhood internalizing problems were correlated with sex and community adversity. Children externalizing problems were correlated with race, sex, service utilization, and community adversity. Childhood internalizing and externalizing problems were highly correlated. Regression analysis reveals a strong relationship between community adversity and childhood externalizing problems. Service utilization was found to significantly and positively moderate the relationship between community adversity and externalizing problems. While a strong correlation between race and childhood externalizing problems exist, race did not moderate the relationship between community adversity and externalizing problems. Internalizing problems were excluded from the regression analysis since it did not correlate with any of the moderator variables. The findings are discussed and the study limitations are examined. Implications for child welfare practice, policy, and research are highlighted.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Achenbach, T. M. (1991). Manual for the Child Behavior Checklist/4–18 and 1991 Profile. Burlington: University of Vermont Department of Psychiatry.

    Google Scholar 

  • Achenbach, T. M., & Rescorla, L. A. (2001). Manual for the ASEBA School-Age Forms & Profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, & Families.

    Google Scholar 

  • Alperstein, G., & Raman, S. (2003). Promoting mental health and emotional well-being among children and youth: a role for community child health? Child: Care. Health & Development, 29(4), 269–274.

    Article  Google Scholar 

  • Aneshensel, C. S., & Sucoff, C. A. (1996). The neighborhood context of adolescent mental health. Journal of Health and Social Behavior, 37(4), 293–310.

    Article  PubMed  Google Scholar 

  • Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182.

    Article  PubMed  Google Scholar 

  • Briggs, H. E., Briggs, A. C., Miller, K. M., & Paulson, R. I. (2011). Combating persistent cultural incompetence in mental health care systems serving African Americans. Best Practices in Mental Health, 7, 1–25.

    Google Scholar 

  • Briggs, H.E., & Paulson, R.I. (1996). Racism. In M. A. Mattaini & B.A. Thyer (Eds.). Finding Solutions to social problems: Behavioral strategies for change (pp. 147-177). Washington, D.C.: US: American Psychological Association.

  • Brooks-Gunn, J., Duncan, G. J., Klebanov, P. K., & Sealand, N. (1993). Do neighborhoods influence child and adolescent development? The American Journal of Sociology, 99(2), 353–395.

    Article  Google Scholar 

  • Brunette, M. F., & Dean, W. (2002). Community mental health care for women with severe mental illness who are parents. Community Mental Health Journal, 38(2), 153–165.

    Article  PubMed  Google Scholar 

  • Burgess, A. L., & Borowsky, I. W. (2010). Health and home environments of caregivers of children investigated by child protective services. Pediatrics, 125(2), 273–281.

    Article  PubMed  Google Scholar 

  • Casanueva, C., Ringeisen, H., Wilson, E., Smith, K., & Dolan, M. (2011). NSCAW II baseline report: Child well-being (OPRE Report #2011-27b). Washington, DC: Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.

  • Casciano, R., & Massey, D. S. (2012). Neighborhood disorder and anxiety symptoms: New evidence from a quasi-experimental study. Health & Place, 18(2), 180–190.

    Article  Google Scholar 

  • Ceballo, R., & McLoyd, V. C. (2002). Social support and parenting in poor, dangerous neighborhoods. Child Development, 73(4), 1310–1321.

    Article  PubMed  Google Scholar 

  • Chow, J. C. C., Jaffee, K., & Snowden, L. (2003). Racial/ethnic disparities in the use of mental health services in poverty areas. American Journal of Public Health, 93(5), 792–797.

    Article  PubMed Central  PubMed  Google Scholar 

  • Conners-Burrow, N. A., McKelvey, L., Pemberton, J. R., Lagory, J., Mesman, G. R., & Whiteside-Mansell, L. (2012). Moderators of the relationship between maternal substance abuse symptoms and preschool children’s behavioral outcomes. Journal of Child and Family Studies, 22(8), 1120–1129. doi:10.1007/s10826-012-9674-1.

    Article  Google Scholar 

  • Cooley-Quille, M., Boyd, R. C., Frantz, E., & Walsh, J. (2001). Emotional and behavioral impact of the exposure to community violence in inner-city adolescents. Journal of Clinical Child Psychology, 30(1), 199–206.

    Article  PubMed  Google Scholar 

  • Dai, D. (2010). Black residential segregation, disparities in spatial access to health care facilities and late-stage breast cancer diagnosis in metropolitan Detroit. Health & Place, 16, 1038–1052.

    Article  Google Scholar 

  • Dowd, K., Dolan, M., Wallin, J., Miller, K., Biemer, P., Aragon-Logan, E., et al. (2011). National survey of child and adolescent well-being II: Data file user’s manual restricted release. Ithaca, NY: National Data Archive on Abuse and Neglect.

    Google Scholar 

  • Duff, C. (2011). Networks, resources and agencies: On the character and production of enabling places. Health and Place, 17(1), 149–156.

    Article  PubMed  Google Scholar 

  • Duhig, A. M., Renk, K., Epstein, M. K., & Phares, V. (2000). Interparental agreement on internalizing, externalizing, and total behavior problems: A meta-analysis. Clinical Psychology: Science and Practice, 7(4), 435–453.

    Google Scholar 

  • DuMont, K. A., Widom, C. S., & Czaja, S. J. (2007). Predictors of resilience in abused and neglected children grown-up: The role of individual and neighborhood characteristics. Child Abuse and Neglect, 31, 255–274.

    Article  PubMed  Google Scholar 

  • Dunn, M. G., Tarter, R. E., Mezzich, A. C., Vanyukov, M., Kirisci, L., & Kirillova, G. (2002). Origins and consequences of child neglect in substance abuse families. Clinical Psychology Review, 22(7), 1063–1090.

    Article  PubMed  Google Scholar 

  • Ellen, I. G., Mijanovich, T., & Dillman, K. N. (2001). Neighborhood effects on health: Exploring the links and assessing the evidence. Journal of Urban Affairs, 23(3–4), 391–408.

    Article  Google Scholar 

  • Gapen, M., Cross, D., Ortigo, K., Graham, A., Johnson, E., Evces, M., & Bradley, B. (2011). Perceived neighborhood disorder, community cohesion, and PTSD symptoms among low-income African Americans in an urban health setting. American Journal of Orthopsychiatry, 81(1), 31–37.

    Article  PubMed  Google Scholar 

  • Garner, A. S., Shonkoff, J. P., Siegel, B. S., Dobbins, M. I., Earls, M. F., Garner, A. S., et al. (2012). Early childhood adversity, toxic stress, and the role of the pediatrician: Translating developmental science into lifelong health. Pediatrics, 129, 224–231.

    Article  Google Scholar 

  • Gewirtz, A. H., DeGarmo, D. S., Plowman, E. J., August, G., & Realmuto, G. (2009). Parenting, parental mental health, and child functioning in families residing in supportive housing. American Journal of Orthopsychiatry, 79(3), 336–347.

    Article  PubMed  Google Scholar 

  • Goodman, S. H., Rouse, M. H., Connell, A. M., Broth, M. R., Hall, C. M., & Heyward, D. (2011). Maternal depression and child psychopathology: A meta-analytic review. Clinical Child and Family Psychology Review, 14(1), 1–27.

    Article  PubMed  Google Scholar 

  • Guagliardo, M. F., Ronzio, C. R., Cheung, I., Chacko, E., & Joseph, J. G. (2004). Physician accessibility: An urban case study of pediatric providers. Health & Place, 10(3), 273–283.

    Article  Google Scholar 

  • Gudiño, O. G., Lau, A. S., Yeh, M., McCabe, K. M., & Hough, R. L. (2009). Understanding racial/ethnic disparities in youth mental health services: Do disparities vary by problem type? Journal of Emotional and Behavioral Disorders, 17(1), 3–16.

    Article  Google Scholar 

  • Guttmannova, K., Szanyi, J. M., & Cali, P. W. (2008). Internalizing and externalizing behavior problem scores: Cross-ethnic and longitudinal measurement invariance of the behavior problem index. Educational and Psychological Measurement, 68(4), 676–694.

    Article  Google Scholar 

  • Hall, H. R., Neeley-Barnes, S. L., Graff, J. C., Krcek, T. E., & Roberts, R. J. (2012). Parental stress in families of children with a genetic disorder/disability and the resiliency model of family stress, adjustment, and adaptation. Issues in Contemporary Pediatric Nursing, 35, 24–44.

    Article  Google Scholar 

  • Herbert, P. L., Sisk, J. E., & Howell, E. A. (2008). When does a difference become a disparity? Conceptualizing racial and ethnic disparities in health. Health Affairs, 27(2), 374–382.

    Article  Google Scholar 

  • Hilmers, A., Hilmers, D. C., & Dave, J. (2012). Neighborhood disparities in access to healthy foods and their effects on environmental justice. American Journal of Public Health, 102(9), 1644–1654.

    Article  PubMed Central  PubMed  Google Scholar 

  • Jaffee, S. R., Caspi, A., Moffitt, T. E., Polo-Tomas, M., & Taylor, A. (2007). Individual, family, and neighborhood factors distinquish resilient from non-resilient maltreated children: A cumulative stressors model. Child Abuse and Neglect, 31, 231–253.

    Article  PubMed Central  PubMed  Google Scholar 

  • Jones, C. P. (2000). Levels of racism: A theoretical framework and a Gardner’s tale. American Journal of Public Health, 90(8), 1212–1215.

    Article  PubMed Central  PubMed  Google Scholar 

  • Jones, C. P. (2001). Invited Commentary: “Race”, racism, and the practice of epidemiology. American Journal of Epidemiology, 154(4), 299–304.

    Article  PubMed  Google Scholar 

  • Jones, C. P. (2014). Systems of power, axes of inequality: Parallels, intersections. Braiding the Strands. Medical Care, 52(10), 71–75.

    Article  Google Scholar 

  • Jones, C. P., Jones, C. Y., Perry, G. S., Barclay, G., & Jones, C. A. (2009). Addressing the social determinants of children’s health: A cliff analogy. Journal of Health Care for the Poor and Underserved, 20, 1–12.

    Article  PubMed  Google Scholar 

  • Kaslow, N. J., Heron, S., Roberts, D. K., Thompson, M., Guessous, O., & Jones, C. (2003). Family and community factors that predict internalizing and externalizing symptoms in low-income, African-American children: A preliminary report. Annals of the New York Academy of Sciences, 1008, 55–68.

    Article  PubMed  Google Scholar 

  • Kessler, R. C., Duncan, G. J., Gennetian, L. A., Katz, L. F., Kling, J. R., Sampson, N. A., et al. (2014). Associations of housing mobility interventions for children in high-poverty neighborhoods with subsequent mental disorders during adolescence. Journal of American Medical Association, 311(9), 937–948.

    Article  Google Scholar 

  • Kirby, J. B., & Kaneda, T. (2005). Neighborhood socioeconomic disadvantage and access to health care. Journal of Health and Social Behavior, 46(1), 15–31.

    Article  PubMed  Google Scholar 

  • Kirby, J. B., & Kaneda, T. (2006). Access to health care: Does neighborhood residential instability matter? Journal of Health and Social Behavior, 47(2), 142–155.

    Article  PubMed  Google Scholar 

  • Kramer, M. R., & Hogue, C. R. (2009). Is segregation bad for health. Epidemiologic Review, 31, 178–194.

    Article  Google Scholar 

  • Lambert, S. F., Boyd, R. C., Cammack, N. L., & Ialongo, N. S. (2012). Relationship proximity to victims of witnessed community violence: Associations with adolescent internalizing and externalizing behaviors. American Journal of Orthopsychiatry, 82(1), 1–9.

    Article  PubMed Central  PubMed  Google Scholar 

  • Li, F., Godinet, M. T., & Arnsberger, P. (2011). Protective factors among families with children at risk of maltreatment: Follow up to early school years. Children and Youth Services Review, 33(1), 139–148.

    Article  Google Scholar 

  • Lillie-Blanton, M., & Hoffman, C. (2005). The role of health insurance coverage in reducing racial/ethnic disparities in healthcare. Health Affairs, 24(2), 398–408.

    Article  PubMed  Google Scholar 

  • Lin, J., Thompson, M. P., & Kaslow, N. J. (2009). The mediating role of social support in the community environment—Psychological distress link among low-income African American women. Journal of Community Psychology, 37(4), 459–470.

    Article  Google Scholar 

  • Luthar, S. S., & Goldstein, A. (2004). Children's exposure to community violence: Implications for understanding risk and resilience. Journal of Clinical Child and Adolescent Psychology, 33(3), 499–505.

    Article  Google Scholar 

  • Madhere, S., Harrell, J., & Royal, C. D. M. (2009). Social ecology, genomics, and African American health: A nonlinear dynamical perspective. Journal of Black Psychology, 35(2), 154–179.

    Article  PubMed Central  PubMed  Google Scholar 

  • Manly, J. T., Oshri, A., Lynch, M., Herzog, M., & Wortel, S. (2013). Child neglect and the development of externalizing behavior problems associations with maternal drug dependence and neighborhood crime. Child Maltreatment, 18(1), 17–29.

    Article  PubMed Central  PubMed  Google Scholar 

  • Martin, A., Gardner, M., & Brooks-Gunn, J. (2012). The mediated and moderated effects of family support on child maltreatment. Journal of Family Issues, 33(7), 920–941.

    Article  PubMed Central  PubMed  Google Scholar 

  • McMurray, A. (2011). Editorial: The enabling community for child and family health. Community Nurse, 40(1), 2–4.

    Article  Google Scholar 

  • Mears, S. L., Yaffe, J., & Harris, N. J. (2009). Evaluation of wraparound services for severely emotionally disturbed youths. Research on Social Work Practice, 19(6), 678–685.

    Article  Google Scholar 

  • Miller, K. M., Anderson-Nathe, B., & Meinhold, J. (2014). Gender and culturally grounded practice. In W. Church, D.W. Springer, & A. Roberts (Eds.). Juvenile Justice Sourcebook: Past, present, and future, (2nd Ed.). (pp. 581–606). Oxford: Oxford University Press.

  • Miller, K. M., & Bank, L. (2013). Moderating effects of race on children’s internalizing and externalizing behaviors who have mothers with child welfare and criminal justice involvement. Children and Youth Services Review, 35(3), 472–481.

    Article  Google Scholar 

  • Miller, K. M., Gil-Kashiwabara, E., Briggs, H. E., & Hatcher, S. (2010). Contexts of race, ethnicity, and culture for children of incarcerated parents. In J. M. Eddy & J. Poehlmann (Eds.), Children of incarcerated parents: A handbook for researchers and practitioners (pp. 141–157). Baltimore MD: The Urban Institute Press.

    Google Scholar 

  • Miller, K. M., Orellana, E. R., Johnson, A. B., Krase, K., & Anderson-Nathe, B. (2013). Maternal criminal justice and child welfare involvement: Associations between risk exposures and childhood mental health. Social Work Research, 37(4), 1–12.

    Article  Google Scholar 

  • Mitchell, S. J., Lewin, A., Horn, I. B., Valentine, D., Sanders-Phillips, K., & Joseph, J. G. (2010). How does violence exposure affect the psychological health and parenting of young African-American mothers? Social Science and Medicine, 70(4), 526–533.

    Article  PubMed  Google Scholar 

  • Moore, L. V., & Roux, A. V. D. (2006). Associations of neighborhood characteristics with the location and type of food stores. American Journal of Public Health, 96(2), 325–331.

    Article  PubMed Central  PubMed  Google Scholar 

  • Mrug, S., & Windle, M. (2010). Prospective effects of violence exposure across multiple contexts on early adolescents’ internalizing and externalizing problems. Journal of Child Psychology and Psychiatry, 51(8), 953–961.

    Article  PubMed  Google Scholar 

  • Mustillo, S. A., Dorsey, S., Conover, K., & Burns, B. J. (2011). Parental depression and child outcomes: The mediating effects of abuse and neglect. Journal of Marriage and Family, 73(1), 164–180.

    Article  Google Scholar 

  • Osypuk, T. L., Schmidt, N. M., Bates, L. M., Tchetgen-Tchetgen, E. J., Earls, F. J., & Glymour, M. M. (2012). Gender and crime victimization modify neighborhood effects on adolescent mental health. Pediatrics, 130(3), 472–481.

    Article  PubMed Central  PubMed  Google Scholar 

  • Paranjape, A., Heron, S., & Kaslow, N. J. (2006). Utilization of services by abused, low-income African-American women. Journal of General Internal Medicine, 21(2), 189–192.

    Article  PubMed Central  PubMed  Google Scholar 

  • Pearlin, L. I. (1995). Some conceptual perspectives on the origins and prevention of social stress. In B. Bruner, M. Stoughton, P. Gibbons, & S. Milmoe (Eds.), Social Stressors: Personal and Social Resources and Their Health consequences. National Institute of Mental Health: Bethesda, MD.

    Google Scholar 

  • Peipins, L. A., Graham, S., Young, R., Lewis, B., Foster, S., Flanagan, B., & Dent, A. (2011). Time and distance barriers to mammography facilitaties in the Atlanta area. Journal of Community Health, 36(4), 675–683.

    Article  PubMed  Google Scholar 

  • Poortinga, W. (2012). Community resilience and health: The role of bonding, bridging, and linking aspects of social capital. Health & Place, 18, 286–295.

    Article  Google Scholar 

  • Putnam, R. (1995). Bowling alone: America’s declining social capital. Journal of Democracy, 6(1), 65–78.

    Article  Google Scholar 

  • Rifkin, S. (2003). A framework linking community empowerment and health equity: It is a matter of CHOICE. Journal of Health and Population Nutrition, 21(3), 168–180.

    Google Scholar 

  • Ringeisen, H., Casanueva, C., Smith, K., & Dolan, M. (2011). NSCAW II baseline report: Caregiver health and services (OPRE Report #2011-27d). Washington, DC: Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.

  • Sellstrom, E., & Bremberg, S. (2006). The significance of neighbourhood context to child and adolescent health and well-being: A systematic review of multilevel studies. Scandinavian Journal of Public Health, 34, 544–554.

    Article  PubMed  Google Scholar 

  • Smith, M. (2004). Parental mental health: disruptions to parenting and outcomes for children. Child and Family Social Work, 9, 3–11.

    Article  Google Scholar 

  • Tyson, E. H. (2004). Ethnic differences using behavior rating scales to assess the mental health of children: A conceptual and psychometric critique. Child Psychiatry and Human Development, 34(3), 167–201.

    Article  PubMed  Google Scholar 

  • Uretsky, M. C., Lee, B. R., Greeno, E. J., & Barth, R. P. (2015). Trajectory of externalizing child behaviors in a KEEP replication. Research on Social Work Practice. doi:10.1177/1049731515576546.

    Google Scholar 

  • Weiner, D. A., Leon, S. C., & Stiehl, M. J. (2011). Demographic, clinical, and geographic predictors of placement disruption among foster care youth receiving wraparound services. Journal of Child and Family Studies, 20(6), 758–770.

    Article  Google Scholar 

  • Weinreb, L., Lessard, D., Goldberg, R., Perloff, J., & Hosmer, D. W. (2006). Factors associated with health service utilization patterns in low-income women. Journal of Health Care for the Poor and Underserved, 17(1), 180–199.

    Article  PubMed  Google Scholar 

  • Wells, S. J., Merritt, L. M., & Briggs, H. E. (2009). Bias, racism and evidence-based practice: The case for more focused development of the child welfare evidence base. Children and Youth Services Review, 31(11), 1160–1171.

    Article  Google Scholar 

  • Wickrama, K. A. S., & Bryant, C. M. (2003). Community context of social resources and adolescent mental health. Journal of Marriage and Family, 65, 850–866.

    Article  Google Scholar 

  • Wickrama, K. A. S., Conger, R. D., & Abraham, W. T. (2005a). Early adversity and later health: The intergenerational transmission of adversity through mental disorder and physical illness. Journal of Gerontology, 60(II), 125–129.

    Article  Google Scholar 

  • Wickrama, K. A. S., Noh, S., & Bryant, C. M. (2005b). Racial differences in adolescent distress: Differential effects of the family and community for blacks and whites. Journal of Community Psychology, 33(3), 261–282.

    Article  Google Scholar 

  • Lynch, M., & Cicchetti, D. (1998). An ecological-transactional analysis of children and contexts: The longitudinal interplay among child maltreatment, community violence, and children’s symptomatology. Development and Psychopathology, 10, 235–257.

    Article  PubMed  Google Scholar 

  • Zenk, S. N., Schulz, A. J., Israel, B. A., James, S. A., Bao, S., & Wilson, M. L. (2005). Neighborhood racial composition, neighborhood poverty, and the spatial accessibility of supermarkets in metropolitan Detroit. American Journal of Public Health, 95(4), 660–667.

    Article  PubMed Central  PubMed  Google Scholar 

  • Zhang, S., & Anderson, S. G. (2010). Low-income single mothers’ community violence exposure and aggressive parenting practices. Children and Youth Services Review, 32(6), 889–895.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Social Work, University of Georgia, Athens, GA, USA

    Harold E. Briggs & Adam Quinn

  2. School of Social Work, Portland State University, Portland, OR, USA

    E. Roberto Orellana & Keva M. Miller

Authors
  1. Harold E. Briggs
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Adam Quinn
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. E. Roberto Orellana
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Keva M. Miller
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Keva M. Miller.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Briggs, H.E., Quinn, A., Orellana, E.R. et al. Community Adversity and Children’s Mental Health: Moderating Effects of Caregiver Service Utilization and Race on Children’s Internalizing and Externalizing Problems. Child Adolesc Soc Work J 32, 555–565 (2015). https://doi.org/10.1007/s10560-015-0395-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10560-015-0395-3

Keywords

Search

Navigation