Integrative Review of Pregnancy Health Risks and Outcomes Associated With Adverse Childhood Experiences

ObjectiveTo estimate the health and financial burden of adverse childhood experiences (ACEs) in England and Wales.DesignThe study combined data from five randomly stratified cross-sectional ACE studies. Population attributable fractions (PAFs) were calculated for major health risks and causes of ill health and applied to disability adjusted life years (DALYs), with financial costs estimated using a modified human capital method.SettingHouseholds in England and Wales.Participants15 285 residents aged 18–69.Outcome measuresThe outcome measures were PAFs for single (1 ACE) and multiple (2–3 and ≥4 ACEs) ACE exposure categories for four health risks (smoking, alcohol use, drug use, high body mass index) and nine causes of ill health (cancer, type 2 diabetes, heart disease, respiratory disease, stroke, violence, anxiety, depression, other mental illness); and annual estimated DALYs and financial costs attributable to ACEs.ResultsCumulative relationships were found between ACEs and risks of all outcomes. For health risks, PAFs for ACEs were highest for drug use (Wales 58.8%, England 52.6%), although ACE-attributable smoking had the highest estimated costs (England and Wales, £7.8 billion). For causes of ill health, PAFs for ACEs were highest for violence (Wales 48.9%, England 43.4%) and mental illness (ranging from 29.1% for anxiety in England to 49.7% for other mental illness in Wales). The greatest ACE-attributable costs were for mental illness (anxiety, depression and other mental illness; England and Wales, £11.2 billion) and cancer (£7.9 billion). Across all outcomes, the total annual ACE-attributable cost was estimated at £42.8 billion. The majority of costs related to exposures to multiple rather than a single ACE (ranging from 71.9% for high body mass index to 98.3% for cancer).ConclusionsACEs impose a substantial societal burden in England and Wales. Policies and practices that prevent ACEs, build resilience and develop trauma-informed services are needed to reduce burden of disease and avoidable service use and financial costs across health and other sectors.

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Health and Adverse Childhood Experiences Among Homeless Youth

10.21203/rs.2.24424/v2 ◽

2020 ◽

Author(s):

Andrew J. Barnes ◽

Amy L. Gower ◽

Mollika Sajady ◽

Katherine A. Lingras

Keyword(s):

Health Status ◽

Health Risks ◽

Adverse Childhood Experiences ◽

Homeless Youth ◽

Chronic Health Conditions ◽

Health Conditions ◽

Childhood Experiences ◽

Chronic Health ◽

Housing Status ◽

Adverse Childhood

Abstract Background and Objectives Homelessness is associated with health problems and with adverse childhood experiences (ACEs). The risk of chronic health conditions for homeless compared to housed youth, and how this risk interacts with ACEs remains unclear. This study investigated the relationship between ACEs, housing, and child health, and whether: 1) ACEs and health vary by housing context; 2) ACEs and homelessness confer independent health risks; and 3) ACEs interact with housing with regard to adolescent health.Methods Using data from 119,254 8th-11th graders, we tested independent and joint effects of ACEs and past-year housing status (housed, family homelessness, unaccompanied homelessness) on overall health and chronic health conditions, controlling for sociodemographic covariates.Results The prevalence of ACEs varied by housing status, with 34.1% of housed youth experiencing ≥1 ACE vs. 56.3% of family-homeless and 85.5% of unaccompanied-homeless youth. Health status varied similarly. Homelessness and ACEs were independently associated with low overall health and chronic health conditions, after adjusting for covariates. Compared to housed youth, both family-homeless youth and unaccompanied-homeless youth had increased odds of low overall health and chronic physical and/or mental health conditions. All ACE x housing-status interactions were significant (all p<0.001), such that ACE-related health risks were moderated by housing status.Conclusions ACEs and housing status independently predict health status during adolescence beyond other sociodemographic risks. Being homeless unaccompanied is also riskier than being homeless with family, and every additional ACE increases this risk. Clinicians and health systems should advocate for policies that include stable housing as a protective factor.

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Health and Adverse Childhood Experiences Among Homeless Youth

10.21203/rs.2.24424/v1 ◽

2020 ◽

Author(s):

Andrew J. Barnes ◽

Amy L. Gower ◽

Mollika Sajady ◽

Katherine A. Lingras

Keyword(s):

Health Status ◽

Health Risks ◽

Adverse Childhood Experiences ◽

Homeless Youth ◽

Chronic Health Conditions ◽

Health Conditions ◽

Childhood Experiences ◽

Chronic Health ◽

Housing Status ◽

Adverse Childhood

Abstract Background and Objectives Homelessness is associated with health problems and with adverse childhood experiences (ACEs). The risk of chronic health conditions for homeless compared to housed youth, and how this risk interacts with ACEs remains unclear. This study investigated the relationship between ACEs, housing, and child health, and whether: 1) ACEs and health vary by housing context; 2) ACEs and homelessness confer independent health risks; and 3) ACEs interact with housing with regard to adolescent health. Methods Using data from 119,254 8th-11th graders, we tested independent and joint effects of ACEs and past-year housing status (housed, family homelessness, unaccompanied homelessness) on overall health and chronic health conditions, controlling for sociodemographic covariates. Results The prevalence of ACEs varied by housing status, with 34.1% of housed youth experiencing ≥1 ACE vs. 56.3% of family-homeless and 85.5% of unaccompanied-homeless youth. Health status varied similarly. Homelessness and ACEs were independently associated with low overall health and chronic health conditions, after adjusting for covariates. Compared to housed youth, both family-homeless youth and unaccompanied-homeless youth had increased odds of low overall health and chronic physical and/or mental health conditions. All ACE x housing-status interactions were significant (all p<0.001), such that ACE-related health risks were moderated by housing status. Conclusions ACEs and housing status independently predict health status during adolescence beyond other sociodemographic risks. Being homeless unaccompanied is also riskier than being homeless with family, and every additional ACE increases this risk. Clinicians and health systems should advocate for policies that include stable housing as a protective factor.

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Association between Maternal Adverse Childhood Experiences and Attention-Deficit/Hyperactivity Disorder in the Offspring: The Mediating Role of Antepartum Health Risks

Journal of korean Academy of Child and Adolescent Psychiatry ◽

10.5765/jkacap.200041 ◽

2021 ◽

Vol 32 (1) ◽

pp. 28-34

Author(s):

Duk-Soo Moon ◽

Su-Jeong Bong ◽

Bung-Nyun Kim ◽

Na Ri Kang

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Health Risks ◽

Attention Deficit ◽

Adverse Childhood Experiences ◽

Childhood Experiences ◽

Mediating Role ◽

Hyperactivity Disorder ◽

Adverse Childhood

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Health and adverse childhood experiences among homeless youth

BMC Pediatrics ◽

10.1186/s12887-021-02620-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Andrew J. Barnes ◽

Amy L. Gower ◽

Mollika Sajady ◽

Katherine A. Lingras

Keyword(s):

Health Status ◽

Health Risks ◽

Adverse Childhood Experiences ◽

Homeless Youth ◽

Chronic Health Conditions ◽

Health Conditions ◽

Childhood Experiences ◽

Chronic Health ◽

Housing Status ◽

Adverse Childhood

Abstract Background Homelessness is associated with health problems and with adverse childhood experiences (ACEs). The risk of chronic health conditions for homeless compared to housed youth, and how this risk interacts with ACEs remains unclear. This study investigated the relationship between ACEs, housing, and child health, and whether: 1) ACEs and health vary by housing context; 2) ACEs and homelessness confer independent health risks; and 3) ACEs interact with housing with regard to adolescent health. Methods Using data from 119,254 8th–11th graders, we tested independent and joint effects of ACEs and past-year housing status (housed, family homelessness, unaccompanied homelessness) on overall health and chronic health conditions, controlling for sociodemographic covariates. Results The prevalence of ACEs varied by housing status, with 34.1% of housed youth experiencing ≥1 ACE vs. 56.3% of family-homeless and 85.5% of unaccompanied-homeless youth. Health status varied similarly. Homelessness and ACEs were independently associated with low overall health and chronic health conditions, after adjusting for covariates. Compared to housed youth, both family-homeless youth and unaccompanied-homeless youth had increased odds of low overall health and chronic physical and/or mental health conditions. All ACE x housing-status interactions were significant (all p < 0.001), such that ACE-related health risks were moderated by housing status. Conclusions ACEs and housing status independently predict health status during adolescence beyond other sociodemographic risks. Experiencing homelessness, whether unaccomapnied or with family, is associated with increased health risk, and every additional ACE increases this risk. Clinicians and health systems should advocate for policies that include stable housing as a protective factor.

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