Department of Demography, 12346University of Texas at San Antonio, San Antonio, TX, USA.
Department of Sociology, 1084University at Albany, State University of New York, New York, NY, USA.
Am J Health Promot. 2021 Jun;35(5):637-647. doi: 10.1177/0890117120982407. Epub 2020 Dec 24.
Research has linked adverse childhood experiences (ACEs) to a host of negative health outcomes in adulthood. However, most existing studies focused on traumatic ACEs and used samples collected from a specific geographic unit (e.g., region, city, or state). This study examines the association between non-traumatic ACEs and health outcomes (i.e., self-rated health and psychological well-being) in adulthood, and assesses the extent to which the cumulative life course poverty accounts for these associations between ACEs and health.
Public and de-identified data from Panel Study of Income Dynamics (PSID) (1968-2013) and its Childhood Retrospective Circumstances Study (CRCS) (2014) ( = 7,126) were used. Episode and severity of childhood adversities of respondents were determined by using comprehensive retrospective circumstance measures.
Multivariate regression models were used to analyze the associations between ACEs and adult health. Mediation analysis was employed to assess the extent to which the associations were explained by cumulative life course poverty. Data analysis was carried out in 2019 using STATA 15.
We found that episode and severity of ACEs were associated with increased risk of poor health and psychological distress. Compared to individuals with no ACEs, one unit increase in the ACE index is associated with 8 and 18 percent increase in the risk of poor health and psychological distress, respectively. A small proportion (4%) of the impact of early adversities on health is attributable to the proportion of adult lifetime spent in poverty.
Non-traumatic ACEs are associated with increased risk for poor health and psychological distress. Life course cumulative experience in poverty accounts for a small portion of the associations. Providing support to prevent ACEs may have long-term health benefits.
研究表明，不良的童年经历（ACEs）与成年后许多负面健康结果有关。然而，大多数现有研究都集中在创伤性 ACEs 上，并使用特定地理区域（例如地区、城市或州）收集的样本。本研究考察了非创伤性 ACEs 与成年后健康结果（即自我评估健康和心理幸福感）之间的关联，并评估了累积人生历程贫困在 ACEs 与健康之间的关联中所占的程度。
使用来自收入动态面板研究（PSID）（1968-2013 年）及其儿童回溯情况研究（CRCS）（2014 年）（=7126）的公共和去识别数据。使用综合回溯情况测量来确定受访者童年逆境的发生和严重程度。
使用多元回归模型分析 ACEs 与成人健康之间的关联。采用中介分析评估累积人生历程贫困对关联的解释程度。数据分析于 2019 年在 STATA 15 中进行。
我们发现，ACEs 的发生和严重程度与健康状况不佳和心理困扰的风险增加有关。与没有 ACEs 的个体相比，ACE 指数每增加一个单位，健康状况不佳和心理困扰的风险分别增加 8%和 18%。早期逆境对健康的影响只有一小部分（4%）归因于成年期生活在贫困中的比例。
非创伤性 ACEs 与健康状况不佳和心理困扰的风险增加有关。人生历程中的累积贫困经历仅占关联的一小部分。提供支持以预防 ACEs 可能会带来长期的健康益处。
