Background
Adverse childhood experiences (ACEs), including child abuse and family dysfunction,
are linked to leading causes of adult morbidity and mortality. Most prior ACE studies
were based on a nonrepresentative patient sample from one Southern California HMO.
Purpose
To determine if ACE exposure increases the risk of chronic disease and disability
using a larger, more representative sample of adults than prior studies.
Methods
Ten states and the District of Columbia included an optional ACE module in the 2010
Behavioral Risk Factor Surveillance Survey, a national cross-sectional, random-digit-dial
telephone survey of adults. Analysis was conducted in November 2012. Respondents were
asked about nine ACEs, including physical, sexual, and emotional abuse and household
member mental illness, alcoholism, drug abuse, imprisonment, divorce, and intimate
partner violence. An ACE score was calculated for each subject by summing the endorsed
ACE items. After controlling for sociodemographic variables, weighted AORs were calculated
for self-reported health conditions given exposure to zero, one to three, four to
six, or seven to nine ACEs.
Results
Compared to those who reported no ACE exposure, the adjusted odds of reporting myocardial
infarction, asthma, fair/poor health, frequent mental distress, and disability were
higher for those reporting one to three, four to six, or seven to nine ACEs. Odds
of reporting coronary heart disease and stroke were higher for those who reported
four to six and seven to nine ACEs; odds of diabetes were higher for those reporting
one to three and four to six ACEs.
Conclusions
These findings underscore the importance of child maltreatment prevention as a means
to mitigate adult morbidity and mortality.
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Article Info
Publication History
Published online: October 06, 2014
Identification
Copyright
Published by Elsevier Inc.
