Session: Targeting What Matters: Translating Evidence on ACEs and Discrimination into Social Work Action (Society for Social Work and Research 31st Annual Conference)

Adolescent suicidal thoughts and behaviors (STBs) and substance use remain urgent public health concerns in the United States, with disproportionate burdens borne by youth exposed to structural and interpersonal adversities. In alignment with the Society for Social Work and Research (SSWR) conference theme—“social work research at the service of democracy: advancing rigorous inquiry for the common good”—this symposium brings together three complementary studies that advance equity-driven, population-based research to better understand how specific forms of adversity shape adolescent health risk behaviors. Moving beyond cumulative risk frameworks, these studies disaggregate adverse childhood experiences (ACEs) and examine structural stressors such as perceived racial discrimination (PRD) to identify actionable pathways for intervention, policy, and practice.

Drawing on nationally representative data from the 2023 Youth Risk Behavior Survey (YRBS), the first study examines the differential effects of nine ACE subtypes on suicidal ideation, planning, and attempts among U.S. adolescents. Findings reveal that interpersonal and community-level adversities—including emotional abuse, sexual abuse, physical neglect, and exposure to neighborhood violence—are consistently associated with elevated suicide risk, with pronounced racial and ethnic disparities in exposure. The second study focuses on racial/ethnic minority adolescents and demonstrates that PRD is a significant predictor of STBs. Importantly, mediation analyses show that persistent sadness or hopelessness is a central mechanism through which discrimination “gets under the skin,” while maladaptive coping behaviors such as vaping further exacerbate vulnerability. The third study extends this work by examining how specific ACE subtypes contribute to adolescent electronic vapor product (EVP) use. Results indicate that emotional abuse, household dysfunction, and neighborhood violence are key drivers of vaping, while psychosocial stressors increase risk and parental monitoring serves as a critical protective factor.

Collectively, these studies highlight that not all adversities confer equal risk; rather, structurally embedded and relational forms of harm disproportionately shape adolescent mental health and behavioral outcomes. By identifying distinct pathways—linking ACEs and discrimination to emotional distress, suicidality, and substance use—this symposium advances a more precise and actionable evidence base for social work.

The implications for social work are substantial. For practice, findings underscore the need for routine, developmentally appropriate screening for specific ACE subtypes, discrimination experiences, and emotional distress across school, healthcare, and community-based settings. Trauma-informed, culturally responsive interventions that address both internalizing symptoms and environmental stressors are essential. For policy, the results call for sustained efforts to address structural determinants of health, including racism, neighborhood violence, and family instability, while expanding equitable access to mental health and prevention services. For research, this work demonstrates the importance of disaggregating adversity and examining mediating mechanisms to inform targeted, multilevel interventions. By centering equity, rigor, and population-level evidence, this symposium contributes to social work’s democratic mission to reduce disparities, promote adolescent well-being, and generate actionable knowledge that serves the common good.