Ye Dailin, Reyes-Salvail Florentina
Hawai'i State Department of Health, Honolulu, HI.
Hawaii J Med Public Health. 2014 Jun;73(6):181-90.
The prevalence of adverse childhood experiences (ACEs) among Hawai'i adults and their impact on the health of affected individuals are unknown. Aiming to provide Hawai'i State baseline information on ACEs and their associations with health conditions and risk behaviors, the 2010 Hawai'i Behavioral Risk Factor Surveillance System (BRFSS) included the ACE module. Using 5,928 survey respondents who completed the module, demographic attributes were estimated and multivariate logistic regression analysis was performed to examine the association between ACEs and sixteen selected health indicators. In 2010, approximately 57.8% of Hawai'i adults reported experiencing at least one ACE. Native Hawaiians had the highest prevalence followed by Whites. Adults aged ≥ 65 years had the lowest prevalence on all ACEs. The prevalence of ACEs was inversely related to education and household income levels. Compared to those without ACEs, adults with ACEs had higher odds for a number of health conditions and risk behaviors. Moreover, as the number of ACEs increased, the odds for these health conditions and risk behaviors increased. Hawai'i adults with ACEs were more likely to report dissatisfaction with life compared to those without ACEs. Men were more likely to report having a family member in prison, while women were more likely to report experiencing sexual abuse. Recommendations include further research on the unbiased contributions of ACEs to diseases and risk behaviors, and the development of culturally-appropriate interventions to reduce the prevalence of ACEs in Hawai'i.
夏威夷成年人中童年不良经历(ACEs)的患病率及其对受影响个体健康的影响尚不清楚。为了提供夏威夷州关于ACEs及其与健康状况和风险行为之间关联的基线信息,2010年夏威夷行为风险因素监测系统(BRFSS)纳入了ACE模块。利用5928名完成该模块的调查受访者,估计了人口统计学特征,并进行了多因素逻辑回归分析,以检验ACEs与16项选定健康指标之间的关联。2010年,约57.8%的夏威夷成年人报告至少经历过一次ACE。夏威夷原住民的患病率最高,其次是白人。65岁及以上的成年人在所有ACEs方面的患病率最低。ACEs的患病率与教育程度和家庭收入水平呈负相关。与没有ACEs的成年人相比,有ACEs的成年人出现多种健康状况和风险行为的几率更高。此外,随着ACEs数量的增加,这些健康状况和风险行为的几率也会增加。与没有ACEs的成年人相比,有ACEs的夏威夷成年人更有可能报告对生活不满意。男性更有可能报告有家庭成员入狱,而女性更有可能报告遭受性虐待。建议包括进一步研究ACEs对疾病和风险行为的无偏贡献,以及制定符合文化背景的干预措施以降低夏威夷ACEs的患病率。