Policy, Research and International Development Directorate, Public Health Wales, Clwydian House, Wrexham, LL13 7YP, UK.
Policy, Research and International Development Directorate, Public Health Wales, Clwydian House, Wrexham, LL13 7YP, UK; Hot House, College of Human Sciences, BIHMR, Bangor University, Wrexham, LL13 7YP, UK.
Public Health. 2018 Dec;165:106-116. doi: 10.1016/j.puhe.2018.09.014. Epub 2018 Oct 30.
Educational and employment outcomes are critical elements in determining the life course of individuals, yet through health and other mechanisms, those who suffer adverse childhood experiences (ACEs) may experience barriers to achieve in these domains. This study examines the association between ACEs and poor educational outcomes, before considering the impact of ACEs and education on employment in adulthood.
Retrospective cross-sectional surveys were conducted in England and Wales using a random stratified sampling methodology.
During face-to-face household interviews (n = 2881), data were collected on demographic factors, ACEs, self-rated childhood affluence, the highest qualification level attained and the current employment status.
While respondents with ≥4 ACEs were significantly more likely to have no formal qualifications (adjusted odds ratio [AOR] = 2.18; P < 0.001), among those who did achieve secondary level qualifications, the presence of ACEs did not further impact subsequent likelihood of going on to attain college or higher qualifications. However, results suggest a persisting independent impact of high (≥4) ACEs, which were found to be significantly associated with both current unemployment (AOR = 2.52, P < 0.001) and long-term sickness and disability (AOR = 3.94, P < 0.001). Modelled levels of not being in employment ranged from as little as 3% among those with 0 or 1 ACE and higher qualifications to 62% among those with no qualifications and ≥4 ACEs (adjusted for age, gender and childhood affluence effects).
Compulsory education may play a pivotal role in mitigating the effects of adversity, supporting the case for approaches within schools that build resilience and tackle educational inequalities. However, adults with ACEs should not be overlooked and efforts should be considered to support them in achieving meaningful employment.
教育和就业结果是决定个人生活轨迹的关键因素，但通过健康和其他机制，那些经历过不良童年经历（ACEs）的人可能会在这些领域遇到障碍。本研究考察了 ACEs 与较差的教育结果之间的关联，然后考虑 ACEs 和教育对成年人就业的影响。
在英格兰和威尔士使用随机分层抽样方法进行回顾性横断面调查。
在面对面的家庭访谈中（n=2881），收集了人口统计学因素、ACEs、自我评估的童年富裕程度、最高学历水平和当前就业状况的数据。
虽然具有≥4 项 ACEs 的受访者获得正式资格的可能性显著更高（调整后的优势比 [AOR] = 2.18；P < 0.001），但在那些确实获得中学水平资格的人中，ACEs 的存在并不会进一步影响随后获得大学或更高学历的可能性。然而，结果表明 ACEs 存在持续的独立影响，发现其与当前失业（AOR = 2.52，P < 0.001）和长期患病和残疾（AOR = 3.94，P < 0.001）显著相关。未就业的模拟水平从 ACEs 为 0 或 1 且拥有更高学历的受访者中低至 3%，到没有资格且 ACEs 为≥4 的受访者中高达 62%（调整了年龄、性别和童年富裕的影响）。
义务教育可能在减轻逆境影响方面发挥关键作用，支持在学校内采取建立韧性和解决教育不平等的方法。然而，不应忽视 ACEs 的成年人，应考虑努力支持他们实现有意义的就业。
