Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Suite 300, 1300 South Second Street, Minneapolis, MN55454, USA.
Department of Nutritional Sciences, College of Health and Human Development, Penn State, 110 Chandlee Lab, University Park, PA16802, USA.
Public Health Nutr. 2023 Nov;26(11):2343-2354. doi: 10.1017/S1368980023001349. Epub 2023 Jul 11.
Low childhood socio-economic status (SES) and adverse childhood experiences (ACE) are associated with poor health outcomes in adulthood. Determining how ACE may be linked to food insecurity among young people from socio-economically diverse households can inform health-protective strategies. This study examined if ACE are associated with food insecurity during the transition to adulthood and investigated prevalence differences across SES strata.
Participants were recruited from twenty secondary schools in Minneapolis-St. Paul, Minnesota.
The analytic sample ( 1518) completed classroom surveys in 2009-2010 (mean age = 14·5 years) and follow-up surveys in 2017-2018 (mean age = 22·0 years).
Past-year food insecurity was reported at both time points, and ACE were reported at follow-up. Logistic regression models were used to estimate emerging adult food insecurity prevalence by ACE exposure; models were stratified by childhood SES (low, middle and high).
The adjusted prevalence of food insecurity was 45·3 % among emerging adults who reported three or more ACE compared with 23·6 % among those with one or two ACE and 15·5 % among those with no ACE ( < 0·001). All forms of ACE were related to an elevated prevalence of food insecurity in emerging adulthood. ACE-food insecurity associations were strongest for emerging adults from lower and middle SES households. Among emerging adults from low SES households, childhood experiences of emotional abuse and substance use by a household member were associated with the largest prevalence differences in food insecurity.
Findings suggest a need for trauma-informed services within food assistance programs to better serve individuals with a history of ACE.
低儿童社会经济地位（SES）和不良儿童经历（ACE）与成年后健康状况不佳有关。确定 ACE 如何与来自社会经济多样化家庭的年轻人的粮食不安全有关，可以为健康保护策略提供信息。本研究考察了 ACE 是否与成年过渡期的粮食不安全有关，并调查了 SES 阶层之间的流行率差异。
参与者从明尼苏达州明尼阿波利斯-圣保罗的二十所中学招募。
分析样本（1518 人）于 2009-2010 年完成课堂调查（平均年龄= 14.5 岁），并于 2017-2018 年完成随访调查（平均年龄= 22.0 岁）。
在两个时间点报告过去一年的粮食不安全情况，并在随访时报告 ACE。使用逻辑回归模型估计 ACE 暴露的成年初期粮食不安全的流行率；模型按儿童 SES（低、中、高）分层。
报告有三种或更多 ACE 的成年初期粮食不安全的调整后流行率为 45.3%，而报告有一到两种 ACE 的流行率为 23.6%，没有 ACE 的流行率为 15.5%（<0.001）。所有形式的 ACE 都与成年初期粮食不安全的高发率有关。ACE-粮食不安全的关联在 SES 较低和中等家庭的成年初期最强。在 SES 较低的家庭中，儿童期经历的情绪虐待和家庭成员的物质滥用与粮食不安全的最大流行率差异有关。
研究结果表明，在粮食援助计划中需要提供创伤知情服务，以更好地为有 ACE 病史的个人提供服务。
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