Household and community-level Adverse Childhood Experiences and adult health outcomes in a diverse urban population

2016 ◽  
Vol 52 ◽  
pp. 135-145 ◽  
Author(s):  
Roy Wade ◽  
Peter F. Cronholm ◽  
Joel A. Fein ◽  
Christine M. Forke ◽  
Martha B. Davis ◽  
...  
2020 ◽  
Author(s):  
Marianna LaNoue ◽  
Brandon J George ◽  
Deborah L Helitzer ◽  
Scott W Keith

Abstract Background A majority of the documented relationships between adverse childhood experiences (ACEs) and adult health outcomes are based in cross-sectional self-reported datasources such as the CDC’s Behavioral Risk Factor Surveillance System survey. Despite using the same or similar questions, there is a great deal of inconsistency in the operationalization of self-reported childhood adversity for use as a predictor variable. A cumulative risk model, resulting in a cumulative numeric ‘ACE Score’, is normative but there are differences in the way the ACE Score is calculated and used in statistical models. Alternative conceptual models are rarely used, even though predictor characterization directly impacts interpretations about the effects of adversity on outcomes. We investigated differences in model fit and performance between the cumulative ACE Score and a ‘multiple individual risk’ model that enters individual ACE events individually into prediction models. Methods We merged the 2011–2012 BRFSS data (N = 56,640) and analyzed 3 self-report outcomes. We compared model fit metrics and used Vuong’s test for model selection to arrive at a best fit model. Results The multiple individual risk model was a better fit than the categorical ACE Score for the ‘lifetime history of depression’ outcome. For the outcomes of obesity and cardiac disease, the cumulative risk and multiple individual risks models were of comparable fit, but yield very different inferences. Conclusions Additional information-rich inferences about ACE-health relationships can be obtained from including a multiple individual risk modeling strategy, either in addition to or in place of a cumulative risk ACE Score.


2018 ◽  
Vol 30 (6) ◽  
pp. 582-591 ◽  
Author(s):  
Paraniala Silas C. Lui ◽  
Michael P. Dunne ◽  
Philip Baker ◽  
Verzilyn Isom

Compared with many parts of the world, there has been little research in Pacific Island nations into the effects of adverse childhood experiences (ACEs) on adult health. This is a significant gap for local evidence-based child protection. We describe findings from a survey of 400 men aged 18 to 70 years recruited from randomly sampled households in Honiara city, Solomon Islands. Most men reported multiple adversities during childhood (80.7% 3 or more; 46% 5 or more), such as exposure to community and domestic violence, bullying, physical maltreatment, and sexual abuse. Men with multiple ACEs had significantly lower well-being and more psychological distress, recent stressful life events, and health risk behaviors. This study reports the first observation that betel quid chewing increased as a function of multiple ACEs. In comparison with recent East Asian studies, the Solomon Islands data suggest that the collective geographic category of “Asia-Pacific” masks significant intraregional differences in childhood adversities.


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