scholarly journals The impact of adverse childhood experiences on health service use across the life course using a retrospective cohort study

2017 ◽  
Vol 22 (3) ◽  
pp. 168-177 ◽  
Author(s):  
Mark Bellis ◽  
Karen Hughes ◽  
Katie Hardcastle ◽  
Kathryn Ashton ◽  
Kat Ford ◽  
...  
Keyword(s):  
Health Care ◽  
Life Course ◽  
Hospital Stay ◽  
Adverse Childhood Experiences ◽  
Service Use ◽  
Health Care Use ◽  
Life Course Perspective ◽  
Childhood Experiences ◽  
Adverse Childhood ◽  
The Impact

Objectives The lifelong health impacts of adverse childhood experiences are increasingly being identified, including earlier and more frequent development of non-communicable disease. Our aim was to examine whether adverse childhood experiences are related to increased use of primary, emergency and in-patient care and at what ages such impact is apparent. Methods Household surveys were undertaken in 2015 with 7414 adults resident in Wales and England using random probability stratified sampling (age range 18–69 years). Nine adverse childhood experiences (covering childhood abuse and household stressors) and three types of health care use in the last 12 months were assessed: number of general practice (GP) visits, emergency department (ED) attendances and nights spent in hospital. Results Levels of use increased with increasing numbers of adverse childhood experiences experienced. Compared to those with no adverse childhood experiences, odds (±95% CIs) of frequent GP use (≥6 visits), any ED attendance or any overnight hospital stay were 2.34 (1.88–2.92), 2.32 (1.90–2.83) and 2.67 (2.06–3.47) in those with ≥ 4 adverse childhood experiences. Differences were independent of socio-economic measures of deprivation and other demographics. Higher health care use in those with ≥ 4 adverse childhood experiences (compared with no adverse childhood experiences) was evident at 18–29 years of age and continued through to 50–59 years. Demographically adjusted means for ED attendance rose from 12.2% of 18-29 year olds with no adverse childhood experiences to 28.8% of those with ≥ 4 adverse childhood experiences. At 60–69 years, only overnight hospital stay was significant (9.8% vs. 25.0%). Conclusions Along with the acute impacts of adverse childhood experiences on child health, a life course perspective provides a compelling case for investing in safe and nurturing childhoods. Disproportionate health expenditure in later life might be reduced through childhood interventions to prevent adverse childhood experiences.

scholarly journals The Relationship Between Adverse Childhood Experiences and Health Care Use in the Manitoba IBD Cohort Study

2019 ◽  
Vol 25 (10) ◽  
pp. 1700-1710 ◽  
Author(s):  
Kelcie M Witges ◽  
Charles N Bernstein ◽  
Kathryn A Sexton ◽  
Tracie Afifi ◽  
John R Walker ◽  
...  
Keyword(s):  
Health Care ◽  
Sexual Abuse ◽  
Cohort Study ◽  
Prescription Drugs ◽  
Adverse Childhood Experiences ◽  
Health Care Use ◽  
Severe Illness ◽  
Childhood Experiences ◽  
Physician Visits ◽  
Adverse Childhood

Abstract Background We aimed to determine the prevalence of adverse childhood experiences (ACEs) in persons with inflammatory bowel disease (IBD) and whether having ACEs was associated with health care utilization post-IBD diagnosis. Method Three hundred forty-five participants from the population-based Manitoba IBD Cohort Study self-reported ACEs (ie, physical abuse, sexual abuse, death of a very close friend or family member, severe illness or injury, upheaval between parents, and any other experience thought to significantly impacts one’s life or personality) at a median of 5.3 years following IBD diagnosis. Cohort study data were linked to administrative health databases that captured use of hospitals, physician visits, and prescription drugs; use was classified as IBD-related and non-IBD-related. Mean annual estimates of health care use were produced for the 60-month period following the ACE report. Generalized linear models (GLMs) with generalized estimating equations (GEEs) with and without covariate adjustment were fit to the data. Results The prevalence of at least 1 ACE was 74.2%. There was no statistically significant association between having experienced an ACE and health care use. However, unadjusted mean annual non-IBD-related general practitioner visits were significantly higher for participants exposed to physical and sexual abuse than those not exposed. Selected adjusted rates of IBD-related health care use were lower for participants who reported exposure to an upheaval between parents and high perceived trauma from ACEs. Conclusion The estimated prevalence of at least 1 self-reported ACE in persons with diagnosed IBD was high. Health care use among those who experienced ACEs may reflect the impacts of ACE on health care anxiety.

Adverse Childhood Experiences: Are They Associated With Greater Risk of Elder Abuse Victimization?

2021 ◽  
pp. 088626052110283
Author(s):  
Mengtong Chen ◽  
Yuanyuan Fu
Keyword(s):  
Life Course ◽  
Adverse Childhood Experiences ◽  
Elder Abuse ◽  
Later Life ◽  
Physical Punishment ◽  
Life Course Perspective ◽  
Self Report ◽  
Childhood Experiences ◽  
Adverse Childhood ◽  
Original Family

Though a growing number of studies have examined the associations between adverse childhood experiences (ACEs) and negative later-life health outcomes, the effects of these early life-course factors on elder abuse victimization have yet to be fully investigated. Using a life-course perspective, this study examines the associations between ACEs and elder abuse victimization. We used data from a cross-sectional survey conducted in Beijing, China. A total of 1,002 older adults were included in this study. Retrospective self-report items were used to measure ACEs and elder abuse victimization in later life. Univariate and multivariate logistic regressions were performed to examine the associations between ACEs and elder abuse victimization. Five types of ACEs (i.e., socio-economic difficulty of the original family, parental divorce, frequent quarrels between parents, frequent physical punishment by parents, and starvation) were associated with a higher risk of elder abuse victimization. After controlling for participants’ socio-demographic characteristics and adding these five types of ACEs simultaneously in the multivariate regression model, the poor socio-economic status of the original family (OR = 1.759, p < .05) and suffering frequent physical punishment inflicted by parents (OR = 2.288, p < .05) were found to be significantly associated with elder abuse victimization. To have multiple (at least 4) ACEs is a risk factor for elder abuse victimization as well (OR = 3.06, p < .001). This study provides evidence for ACEs as risk factors for elder abuse victimization. The findings highlight the importance of strengthening our understanding of the impacts of ACEs in both research and practice.

Adverse Childhood Experiences and Physical and Mental Health of Adults: Assessing the Mediating Role of Cumulative Life Course Poverty

2020 ◽  
pp. 089011712098240
Author(s):  
Ying Huang ◽  
Han Liu ◽  
Muntasir Masum
Keyword(s):  
Psychological Distress ◽  
Life Course ◽  
Health Outcomes ◽  
Adverse Childhood Experiences ◽  
Well Being ◽  
Poor Health ◽  
Childhood Experiences ◽  
Adverse Childhood ◽  
Increased Risk ◽  
The Impact

Objectives: Research has linked adverse childhood experiences (ACEs) to a host of negative health outcomes in adulthood. However, most existing studies focused on traumatic ACEs and used samples collected from a specific geographic unit (e.g., region, city, or state). This study examines the association between non-traumatic ACEs and health outcomes (i.e., self-rated health and psychological well-being) in adulthood, and assesses the extent to which the cumulative life course poverty accounts for these associations between ACEs and health. Data Source: Public and de-identified data from Panel Study of Income Dynamics (PSID) (1968-2013) and its Childhood Retrospective Circumstances Study (CRCS) (2014) ( N = 7,126) were used. Episode and severity of childhood adversities of respondents were determined by using comprehensive retrospective circumstance measures. Methods: Multivariate regression models were used to analyze the associations between ACEs and adult health. Mediation analysis was employed to assess the extent to which the associations were explained by cumulative life course poverty. Data analysis was carried out in 2019 using STATA 15. Results: We found that episode and severity of ACEs were associated with increased risk of poor health and psychological distress. Compared to individuals with no ACEs, one unit increase in the ACE index is associated with 8 and 18 percent increase in the risk of poor health and psychological distress, respectively. A small proportion (4%) of the impact of early adversities on health is attributable to the proportion of adult lifetime spent in poverty. Conclusions: Non-traumatic ACEs are associated with increased risk for poor health and psychological distress. Life course cumulative experience in poverty accounts for a small portion of the associations. Providing support to prevent ACEs may have long-term health benefits.

scholarly journals Building Resilience Against the Sequelae of Adverse Childhood Experiences: Rise Up, Change Your Life, and Reform Health Care

2019 ◽  
Vol 13 (5) ◽  
pp. 470-479 ◽  
Author(s):  
Robin Ortiz
Keyword(s):  
Health Care ◽  
Adverse Childhood Experiences ◽  
Emotional Abuse ◽  
Lifestyle Modification ◽  
Disease Risk ◽  
Traumatic Experiences ◽  
Childhood Experiences ◽  
Building Resilience ◽  
Adverse Childhood ◽  
The Impact

A reformed approach to health care tackles health at its roots. Adverse childhood experiences (ACEs) in those exposed to them may contribute significantly to the root causes of many diseases of lifestyle. ACEs are traumatic experiences, such as physical and emotional abuse and exposure to risky family environments. In 1998, a ground-breaking study found that nearly 70% of Americans experience at least 1 ACE in their lifetime, and graded exposure is associated with the presence of mental health disorders, heart disease, cancer, and other chronic diseases. Over the past 20 years, evidence has demonstrated further disease risk, outcomes, and epigenetic underpinnings in children and adults with ACEs. Building resilience—the capacity to adapt in healthy ways to traumatic experiences—through lifestyle modification offers potential to combat the negative health effects associated with ACEs. Emerging research demonstrates resilience is cultivated through individual skills (emotional intelligence, coping, and fostering healthy lifestyle choices), and nurturing supportive relationships. Being mindful of the impact and prevalence of ACEs and diversity of individuals’ experiences in society will help build resilience and combat the root cause of chronic disease. This review aims to cultivate that awareness and will discuss 3 objectives: to discuss the effects and hypothesized pathophysiological underpinnings of traumatic experiences in childhood on health and wellbeing throughout life, to present ways we can promote resilience in our daily lives and patient encounters, and to demonstrate how advocacy for the reduction of ACEs and promotion of resilient, trauma-informed environments are fundamental to health care reform.

scholarly journals EFFECT OF ADVERSE CHILDHOOD EXPERIENCES ON DAILY SUPPORT TO FAMILY AND EMOTIONAL WELL-BEING IN ADULTHOOD

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S235-S235
Author(s):  
Jooyoung Kong ◽  
Yin Liu ◽  
David Almeida
Keyword(s):  
Negative Affect ◽  
Family Relationships ◽  
Emotional Support ◽  
Adverse Childhood Experiences ◽  
Family Members ◽  
Well Being ◽  
National Study ◽  
Childhood Experiences ◽  
Adverse Childhood ◽  
The Impact

Abstract Extensive evidence suggests that adverse childhood experiences (ACEs) can lead to negative health effects across a lifetime. This study examines the impact of ACEs on the frequency of providing daily support (i.e., unpaid assistance, emotional support, and disability-related assistance) to family members and the moderating effects of ACEs in the association between providing daily support to family and daily negative affect. Using the National Study of Daily Experiences II, we analyzed a total of 14,912 daily interviews from 2,022 respondents aged 56 on average. Key results showed that a greater number of ACEs were associated with providing more frequent emotional support to family. We also found the significant interaction effect that adults with more ACEs showed greater negative affect on the days when they provided assistance to family members with disabilities. The findings underscore the long-term negative impact of ACEs on daily well-being in the context of family relationships.

Early Adverse Childhood Experiences and Self-Control Development among Youth in Fragile Families

2021 ◽  
pp. 0044118X2199637
Author(s):  
Melissa S. Jones ◽  
Hayley Pierce ◽  
Constance L. Chapple
Keyword(s):  
Life Course ◽  
Adverse Childhood Experiences ◽  
Behavioral Outcomes ◽  
Self Control ◽  
Fragile Families ◽  
Childhood Experiences ◽  
Considerable Research ◽  
Adverse Childhood ◽  
Using Data

Though considerable research links both a lack of self-control and adverse childhood experiences (ACEs) to a variety of negative health and behavioral outcomes, few studies to date have explored whether ACEs are associated with deficits in self-control. Using data from the Fragile Families and Child Wellbeing Study (FFCW; n = 3,444) and a life course theoretical framework, this study aims to address this gap in the literature by examining the relationships between individual ACEs, cumulative ACEs, timing of ACEs, and durations of early ACEs and self-control development among youth. Our results indicate that as the number of ACEs (by age 5) experienced incrementally increases, the likelihood of reported self-control decreases. Moreover, when it comes to the timing and duration of ACE exposure, ACEs that are high but late, intermittent, or chronically high significantly decrease self-control. Based on our findings, researchers should continue to explore the role of ACEs in youth self-control development.

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