Adebiyi Ebenezer, Pietri-Toro Jariselle, Awujoola Adeola, Gwynn Lisa
Department of Pediatrics, University of Miami/Jackson Health System, Miami, FL 33136, USA.
Department of Pediatrics, BronxCare Health System, New York, NY 10457, USA.
Children (Basel). 2023 Mar 1;10(3):486. doi: 10.3390/children10030486.
Adverse Childhood Experiences (ACEs) have been associated with a higher risk of developing cardiovascular diseases and premature mortality in adults.
We evaluated the associations between ACEs and heart diseases among children in the United States.
Data on children ages 0 to 17 years reported by parents/guardians to have current heart conditions were analyzed. Using Stata version 17 software, descriptive statistics were generated for the demographic characteristics and the various health outcomes using the chi-square of independence. Multivariate logistic regression models were employed to determine the associations between ACEs and heart conditions, the severity of heart conditions, and overall health status.
There were 826 children with current heart conditions from a total of 68,753 surveyed children. This corresponded to an estimated 780,000 (1.13%) children living with heart conditions in the U.S. On multivariate logistic models, several ACEs, including household economic hardship, parental/guardian's alcohol/drug abuse, severe mental health illness of parents/guardians, racial/ethnic discrimination, exposure to neighborhood violence, and accumulation of two or more ACEs, were significantly associated with heart diseases among children. Though the accumulation of two or more ACEs did not have a significant association with the severity of heart condition, it was significantly associated with caregiver reports of undesirable overall health status.
ACEs are significantly associated with heart conditions among children and contribute to unfavorable overall health status among children with heart conditions in the U.S. There is a need for policies and programs that will promptly identify ACEs and mitigate their negative impact on children.
童年不良经历(ACEs)与成年人患心血管疾病和过早死亡的风险较高有关。
我们评估了美国儿童中ACEs与心脏病之间的关联。
分析了父母/监护人报告的0至17岁患有当前心脏病的儿童数据。使用Stata 17软件,通过独立性卡方检验对人口统计学特征和各种健康结果进行描述性统计。采用多变量逻辑回归模型来确定ACEs与心脏病、心脏病严重程度以及总体健康状况之间的关联。
在总共68,753名接受调查的儿童中,有826名患有当前心脏病。这相当于美国估计有780,000名(1.13%)患有心脏病的儿童。在多变量逻辑模型中,几种ACEs,包括家庭经济困难、父母/监护人酗酒/滥用药物、父母/监护人的严重心理健康疾病、种族/族裔歧视、接触邻里暴力以及两种或更多种ACEs的累积,与儿童心脏病显著相关。虽然两种或更多种ACEs的累积与心脏病严重程度没有显著关联,但与照顾者报告的不良总体健康状况显著相关。
ACEs与美国儿童的心脏病显著相关,并导致患有心脏病的儿童总体健康状况不佳。需要制定政策和计划,以便及时识别ACEs并减轻其对儿童的负面影响。