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Estimated Proportion of Adult Health Problems Attributable to Adverse Childhood Experiences and Implications for Prevention — 25 States, 2015–2017

Bibliographic Data

ID23342191
AuthorsMelissa T Merrick (0000-0003-2001-1025, corresponding author), Dabney Ford (0000-0002-1743-1662), DEREK C FORD, Katie A Ports, Angie S Guinn, Jieru Chen (0000-0003-4241-9590), Joanne Klevens (0000-0003-4151-8853), Marilyn Metzler, Christopher M Jones (0000-0002-6504-6224), Thomas R Simon (0000-0002-3280-2716), Valerie M Daniel, Phyllis Ottley, James A Mercy (0000-0003-1433-2981)
Year2019
Volume68
Issue44
Pages999-1005
Publication date2019-11-08
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueMMWR. Surveillance Summaries (JOURNAL)
Journal identifiersISSN: 1546-0738 • E-ISSN: 1545-8636
PublisherCenters for Disease Control MMWR Office (PUBLISHER)
DOI10.15585/mmwr.mm6844e1
PMID31697656
OpenAlexW2983439809
LanguageEN
Citations received136
References cited16

INTRODUCTION: Adverse childhood experiences, such as violence victimization, substance misuse in the household, or witnessing intimate partner violence, have been linked to leading causes of adult morbidity and mortality. Therefore, reducing adverse childhood experiences is critical to avoiding multiple negative health and socioeconomic outcomes in adulthood. METHODS: Behavioral Risk Factor Surveillance System data were collected from 25 states that included state-added adverse childhood experience items during 2015-2017. Outcomes were self-reported status for coronary heart disease, stroke, asthma, chronic obstructive pulmonary disease, cancer (excluding skin cancer), kidney disease, diabetes, depression, overweight or obesity, current smoking, heavy drinking, less than high school completion, unemployment, and lack of health insurance. Logistic regression modeling adjusting for age group, race/ethnicity, and sex was used to calculate population attributable fractions representing the potential reduction in outcomes associated with preventing adverse childhood experiences. RESULTS: Nearly one in six adults in the study population (15.6%) reported four or more types of adverse childhood experiences. Adverse childhood experiences were significantly associated with poorer health outcomes, health risk behaviors, and socioeconomic challenges. Potential percentage reductions in the number of observed cases as indicated by population attributable fractions ranged from 1.7% for overweight or obesity to 23.9% for heavy drinking, 27.0% for chronic obstructive pulmonary disease, and 44.1% for depression. CONCLUSIONS AND IMPLICATIONS FOR PUBLIC HEALTH PRACTICE: Efforts that prevent adverse childhood experiences could also potentially prevent adult chronic conditions, depression, health risk behaviors, and negative socioeconomic outcomes. States can use comprehensive public health approaches derived from the best available evidence to prevent childhood adversity before it begins. By creating the conditions for healthy communities and focusing on primary prevention, it is possible to reduce risk for adverse childhood experiences while also mitigating consequences for those already affected by these experiences.

Adverse effect · Behavioral Risk Factor Surveillance System · Environmental health · Obesity · Overweight · Pathology · Population · Public health · Socioeconomic status · Child Abuse and Related Trauma · Child Abuse and Trauma · Demography · Gun Ownership and Violence Research · Internal Medicine · Medicine · Gerontology · Pediatrics

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Unique citing works136
Citations per year22,67
Citation span2020 - 2026 (7)
Citation velocitycurrent
Highly citedYes
Citation typesNeutral: 121

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