Smith Eric, Milaney Katrina, Henderson Rita I, Crowshoe Lyndon
University of Calgary, 3280 Hospital Dr NW, Calgary, AB, T2N 4Z6, Canada.
University of Calgary, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada.
BMC Public Health. 2021 Jan 7;21(1):85. doi: 10.1186/s12889-020-10091-y.
Current literature has established that adverse childhood experiences (ACEs) are associated with the onset of a variety of physical, mental, and behavioural illnesses. However, there are few studies that have thoroughly examined this association in low-income or marginalized groups.
To address this knowledge gap, this study used self-reported data on childhood experiences and adult health outcomes in a sample of 91 Indigenous persons experiencing homelessness. While the primary focus of the study was to assess the relationship between ACEs and health status, we also assessed reports on use and perceptions of health care services to test for potential illness-mitigating factors.
Results indicated that reported number of ACEs was significantly associated with reported levels of mental illness (p < .001, d = 1.12). Significant associations were not observed for physical illness or patterns of substance use. We also found that the number of reported ACEs was significantly correlated with the number of formal health care services that an individual used (r = 0.32).
Our results reveal that the relationship between ACEs and adult illness is not as deterministic as the current literature suggests. Access to formal health care services may allow individuals to mitigate their adverse health, thereby eliminating some of the effects of ACEs. Conversely, current tools used to measure ACEs may not translate to an Indigenous population, which speaks to a need to revise ACE related surveys to include additional adversity categories.
当前文献表明，童年不良经历（ACEs）与多种身体、心理和行为疾病的发病有关。然而，很少有研究在低收入或边缘化群体中全面考察这种关联。
为填补这一知识空白，本研究使用了91名无家可归的原住民样本中关于童年经历和成人健康结果的自我报告数据。虽然该研究的主要重点是评估ACEs与健康状况之间的关系，但我们也评估了关于医疗服务使用情况和看法的报告，以测试潜在的疾病缓解因素。
结果表明，报告的ACEs数量与报告的精神疾病水平显著相关（p <.001，d = 1.12）。在身体疾病或物质使用模式方面未观察到显著关联。我们还发现，报告的ACEs数量与个人使用的正规医疗服务数量显著相关（r = 0.32）。
我们的结果表明，ACEs与成人疾病之间的关系并不像当前文献所暗示的那样具有确定性。获得正规医疗服务可能使个人减轻其不良健康状况，从而消除ACEs的一些影响。相反，目前用于衡量ACEs的工具可能不适用于原住民群体，这表明需要修订与ACEs相关的调查，以纳入更多的逆境类别。
