Adverse Childhood Experiences among Adults in North Carolina, USA

Influences on Risk Factors for Poor Health across the Lifespan and Intergenerational Implications

Bibliographic Data

ID15512653
AuthorsAdam Hege (0000-0003-2515-6848, Appalachian State University, corresponding author), Erin D Bouldin (0000-0001-7550-309X, Appalachian State University), Erin Bouldin (Appalachian State University), Manan Roy (0000-0001-5886-3659, Appalachian State University), Maggie Bennett (Columbia University), Peyton R Attaway (0000-0002-8269-2498, RTI International), Kellie Reed-Ashcraft (Appalachian State University)
Year2020
Volume17
Issue22
Pages8548-8548
Publication date2020-11-18
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueInternational Journal of Environmental Research and Public Health (JOURNAL)
Journal identifiersISSN: 1661-7827 • E-ISSN: 1660-4601
PublisherMultidisciplinary Digital Publishing Institute (PUBLISHER • CH)
DOI10.3390/ijerph17228548
PMID33218030
OpenAlexW3104723923
LanguageEN
Citations received3
References cited55

Adverse childhood experiences (ACEs) are a critical determinant and predictor of health across the lifespan. The Appalachian region of the United States, particularly the central and southern portions, experiences worse health outcomes when compared to the rest of the nation. The current research sought to understand the cross-sectional relationships between ACEs, social determinants of health and other health risk factors in one southcentral Appalachian state. Researchers used the 2012 and 2014 North Carolina Behavioral Risk Factor Surveillance System (BRFSS) for analyses. An indicator variable of Appalachian county ( n = 29) was used to make comparisons against non-Appalachian counties ( n = 71). Analyses further examined the prevalence of ACEs in households with and without children across Appalachian and non-Appalachian regions, and the effects of experiencing four or more ACEs on health risk factors. There were no statistically significant differences between Appalachian and non-Appalachian counties in the prevalence of ACEs. However, compared with adults in households without children, those with children reported a higher percentage of ACEs. Reporting four or more ACEs was associated with higher prevalence of smoking (prevalence ratio [PR] = 1.56), heavy alcohol consumption (PR = 1.69), overweight/obesity (PR = 1.07), frequent mental distress (PR = 2.45), and food insecurity (PR = 1.58) in adjusted models and with fair or poor health only outside Appalachia (PR = 1.65). Residence in an Appalachian county was independently associated with higher prevalence of food insecurity (PR = 1.13). Developing programs and implementing policies aimed at reducing the impact of ACEs could improve social determinants of health, thereby helping to reduce health disparities

Adverse Childhood Experiences · Appalachia · Behavioral Risk Factor Surveillance System · Environmental health · Health equity · Mental health · Obesity · Overweight · Population · Psychiatry · Public health · Residence · Social determinants of health · Child Abuse and Trauma · Demography · Health disparities and outcomes · Homelessness and Social Issues · Medicine · Gerontology

Tools

Open DOIOpen Access