Bellis Mark A, Lowey Helen, Leckenby Nicola, Hughes Karen, Harrison Dominic
Centre for Public Health, Liverpool John Moores University, 15-21 Webster Street, Liverpool L3 2ET, UK.
J Public Health (Oxf). 2014 Mar;36(1):81-91. doi: 10.1093/pubmed/fdt038. Epub 2013 Apr 14.
Studies suggest strong links between adverse childhood experiences (ACEs) and poor adult health and social outcomes. However, the use of such studies in non-US populations is relatively scarce.
Retrospective cross-sectional survey of 1500 residents and 67 substance users aged 18-70 years in a relatively deprived and ethnically diverse UK population.
Increasing ACEs were strongly related to adverse behavioural, health and social outcomes. Compared with those with 0 ACEs, individuals with 4+ ACEs had adjusted odds ratios of the following: 3.96 [95% confidence interval (CI): 2.74-5.73] for smoking; 3.72 (95% CI: 2.37-5.85) for heavy drinking; 8.83 (95% CI: 4.42-17.62) for incarceration and 3.02 (95% CI: 1.38-6.62) for morbid obesity. They also had greater risk of poor educational and employment outcomes; low mental wellbeing and life satisfaction; recent violence involvement; recent inpatient hospital care and chronic health conditions. Higher ACEs were also associated with having caused/been unintentionally pregnant aged <18 years and having been born to a mother aged <20 years.
ACEs contribute to poor life-course health and social outcomes in a UK population. That ACEs are linked to involvement in violence, early unplanned pregnancy, incarceration, and unemployment suggests a cyclic effect where those with higher ACE counts have higher risks of exposing their own children to ACEs.
研究表明童年不良经历（ACEs）与成年人健康状况不佳及社会不良后果之间存在紧密联系。然而，此类研究在非美国人群中的应用相对较少。
对英国一个相对贫困且种族多样的地区1500名18至70岁居民及67名药物使用者进行回顾性横断面调查。
ACEs增加与不良行为、健康及社会后果密切相关。与无ACEs者相比，有4种及以上ACEs的个体，以下情况的调整后比值比为：吸烟，3.96[95%置信区间（CI）：2.74 - 5.73]；酗酒，3.72（95%CI：2.37 - 5.85）；入狱，8.83（95%CI：4.42 - 17.62）；病态肥胖，3.02（95%CI：1.38 - 6.62）。他们在教育和就业方面不良结果的风险也更高；心理健康和生活满意度较低；近期有暴力行为；近期有住院治疗及慢性健康问题。较高的ACEs还与18岁以下导致/意外怀孕以及母亲年龄小于20岁生育有关。
ACEs导致英国人群出现不良的生命历程健康和社会后果。ACEs与暴力行为、早期意外怀孕、入狱及失业有关，这表明存在一种循环效应，即ACEs计数较高的人使自己孩子暴露于ACEs的风险更高。
