In past decades, adverse childhood experiences (ACEs) rapidly gained attentionas a public health crisis due to dose-response relationships with a range of health and social problems, and early mortality. Converging studies show that ACEs are a pandemic in the general population of the United States—even in middle to upper-middle class families that are considered to be ‘better off’. There have been collaborative efforts in public health to target root-causes of childhood adversity and increase resilient adaptation in individuals and families at risk. Due to the importance of fostering positive adaptation in the midst of adversity, this dissertation sought to examine both vulnerability and protective factors in children’s proximal ecology—e.g., parents and caring adults at school. A population-based study in this dissertation revealed that parents’ emotional well-being, measured as negative feelings toward parenting, greatly influences developing children, so as support and resources for parenting. The presence of caring adults as a protective factor in teens with highly competitive settings—a newly identified at-risk group due to high pressure to achieve and internalizing/externalizing problems. Lastly, this dissertation discusses conceptual and methodological limitations in current ways of measuring ACEs and provide future directions for research, practice, and policy. Suggestions include frequent assessments on reaching consensus on how to define ACEs, expanding the concept of ACEs, considering the duration, timing, and severity of the event. Healthcare professionals have important roles in public health; they incorporate frequent assessments on parents’ emotional wellbeing and needs for parenting as a part of care. Ongoing support from multiple disciplines is necessary to reduce the impact of ACEs and strengthen resilience development of children and families.

The purpose of this study was to determine if a relationship existed between acculturative stress and cardiovascular disease risk factors in Korean immigrants residing in the United States. This is a secondary analysis of existing data that was collected for a cross-sectional, descriptive study of 104 Korean American adults in a large Southwestern city in the U.S. Descriptive statistics, t-test, and analysis of variance were used to analyze data on demographics, acculturative stress, and biomarkers indicative of cardiovascular risk, such as body mass index (BMI), blood pressure (BP), and total cholesterol (TC). Most participants were women (66.3%), with a mean age of 53.59 (SD = 10.42), who were married (89.4%), educated at a college level or above (graduate) level (85.6%), employed full/part-time (64.4%), and had an annual household income of $50,000 or more (62.5%). The average length of residence in the U.S. was 22.04 years (SD = 11.89), Half of the study sample were overweight or obese (BMI > 23 kg/m2), 65.4% with high SBP (≥ 120 mmHg), 75.9% with high DBP (≥ 80 mmHg), and 75% with high TC (≥ 170 mg/dL). Acculturative stress was significantly associated with age, length of residence, and family annual income. Cardiovascular risk factors were significantly different by age, gender, marital status, education level, or employment status. However, the relationship between acculturative stress and cardiovascular risk indicators was not statistically significant. The study findings provide useful information about demographic characteristics, acculturative stress, and cardiovascular health of Korean immigrants in the United States. In order to prevent and manage cardiovascular health of the population, healthcare professionals should consider that cardiovascular risk factors may vary according to demographic characteristics in Korean immigrants.