Institute of Child Development, University of Minnesota, Minneapolis, MN, United States of America; Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, United States of America.
Institute of Child Development, University of Minnesota, Minneapolis, MN, United States of America.
Prev Med. 2021 Jul;148:106557. doi: 10.1016/j.ypmed.2021.106557. Epub 2021 Apr 18.
Adverse Childhood Experiences (ACEs) have been definitively linked with cross-domain life course well-being. While scales measuring the ten "Conventional" ACEs (ACEs-C; intrafamilial experiences of abuse, neglect, and household dysfunction) are parsimonious, use of such scales alone may fail to capture crucial information about adversity, particularly in youth growing up in underresourced areas. Patterns and disparities in Conventional and Expanded ACEs (ACEs-E; experiences more common in impoverished and densely populated areas) were examined in the large, primarily Black Chicago Longitudinal Study cohort. This cohort has been followed from the 1980s to the present. Participants in the present study, comprising over 70% of the original sample, responded to a follow-up survey between 2012 and 2017. ACE information was collected both prospectively and retrospectively. Overall ACE prevalence and differences in ACEs by sex and risk were explored using logistic regression with adjusted and unadjusted odds ratios, and chi-squared tests. Higher sociodemographic risk in early childhood was associated with higher rates of ACEs-C through adolescence. Males endorsed higher rates of ACEs-E, particularly relating to violent crime. Nearly 1/5 of participants reported only ACEs-E, which are often not measured when assessing ACEs. Findings underscore enduring effects of early childhood risk factors on ACE exposure, as well as contributions of community characteristics to childhood adversity. Given strong associations between ACEs, environment, and well-being, enhancing inclusivity in our understanding of childhood adversity is a public health priority.
不良的童年经历（ACEs）与跨领域的生活幸福感有着明确的联系。虽然衡量十种“传统” ACEs（ACEs-C；家庭内的虐待、忽视和家庭功能障碍）的量表是简洁的，但仅使用这些量表可能无法捕捉到有关逆境的关键信息，尤其是在资源匮乏地区长大的年轻人。在大型的、主要是黑人的芝加哥纵向研究队列中，研究了传统 ACEs 和扩展 ACEs（ACEs-E；在贫困和人口密集地区更为常见的经历）的模式和差异。本队列自 20 世纪 80 年代以来一直跟踪研究。本研究的参与者由超过 70%的原始样本组成，他们在 2012 年至 2017 年期间对后续调查做出了回应。前瞻性和回顾性地收集了 ACE 信息。使用调整和未调整的优势比以及卡方检验，探索了 ACE 总体患病率和性别以及风险因素差异。童年早期的社会人口学风险较高与 ACEs-C 相关的青少年时期的 ACEs 发生率较高相关。男性报告的 ACEs-E 发生率较高，特别是与暴力犯罪相关的 ACEs-E。近 1/5的参与者报告只有 ACEs-E，而在评估 ACEs 时往往不包括这些。这些发现强调了早期儿童风险因素对 ACE 暴露的持久影响，以及社区特征对儿童逆境的贡献。鉴于 ACEs、环境和幸福感之间存在很强的关联，增强我们对儿童逆境的包容性理解是公共卫生的重点。
