A hypothetical intervention to reduce inequities in anxiety for Multiracial people: simulating an intervention on childhood adversity.

Multiracial people report higher mean Adverse Childhood Experience (ACE) scores and prevalence of anxiety than other racial groups. Studies using statistical interactions to test if associations between ACEs and anxiety are greater for this group than others have shown mixed results. Using data from waves 1 (1995-1997) through 4 (2008-2009) of the National Longitudinal Study of Adolescent to Adult Health (Add Health), we simulated a stochastic intervention over 1000 resampled datasets to estimate the race-specific cases averted per 1000 of anxiety if all racial groups had the same exposure distribution of ACEs as Whites. Simulated cases averted were greatest for the Multiracial group, (median = -4.17 cases per 1000; 95% CI; -7.42 to -1.86). The model also predicted smaller risk reductions for Black participants (-0.76; 95% CI, -1.53 to -0.19). CIs around estimates for other racial groups included the null. An intervention to reduce racial disparities in exposure to ACEs could help reduce the inequitable burden of anxiety on the Multiracial population. Stochastic methods support consequentialist approaches to racial health equity, and can encourage greater dialogue between public health researchers, policymakers, and practitioners. This article is part of a Special Collection on Mental Health.