Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 1130033, Japan.
Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan.
BMC Public Health. 2023 Aug 24;23(1):1616. doi: 10.1186/s12889-023-16557-z.
This study aimed to examine whether having adverse childhood experiences (ACEs) was associated with living in a deprived area in adulthood.
The cross-sectional study was conducted by using nation-wide data in 2022 of the Japan COVID-19 and Society Internet Survey (JACSIS). Participants were community dwelling people 18 years or older. ACEs were assessed by Japanese version of 15-items ACE measurement tool (ACE-J). Living condition was measured by Area Deprived Index (ADI) and Densely Inhabited District (DID) based on zip code. Multivariable logistic regression to analyze the associations between ADI and ACE 4 + was conducted, controlling for individual-level factors, such as age, sex, marital status, and education, as an additional analysis.
The total of 27,916 participants were included in the analysis. The prevalence of emotional neglect, childhood poverty, and school bullying were 38.2%, 26.5%, 20.8%, respectively. 75% of the population had one or more ACE(s). The number of ACEs was associated with significantly higher risk of living in deprived area in the adulthood (p = 0.001). ACEs were not associated with living in density area. The association between ADI and ACEs 4 + was non-significant after controlling the individual-level factors.
People with higher number of ACEs tend to live in deprived areas in adulthood. Policy makers in highly deprived areas can apply the trauma-informed approach for the community care and support, which is critical to mitigating deficit perspectives and facilitating comprehensive support for those with ACEs.
本研究旨在探讨成年后患不良童年经历（ACEs）是否与生活在贫困地区有关。
本横断面研究使用了 2022 年日本 COVID-19 和社会互联网调查（JACSIS）的全国性数据。参与者为 18 岁及以上的社区居民。ACEs 通过日本版 15 项 ACE 测量工具（ACE-J）进行评估。生活条件通过邮政编码衡量的区域剥夺指数（ADI）和人口密集区（DID）进行测量。多变量逻辑回归分析了 ADI 和 ACE 4+之间的关联，并进行了个体水平因素的控制，如年龄、性别、婚姻状况和教育程度，作为附加分析。
共有 27916 名参与者纳入分析。情感忽视、童年贫困和校园欺凌的患病率分别为 38.2%、26.5%和 20.8%。75%的人有一个或多个 ACE。ACE 的数量与成年后患贫困地区的风险显著相关（p=0.001）。ACE 与居住在人口密集区无关。控制个体水平因素后，ADI 和 ACE 4+之间的关联无统计学意义。
ACE 较多的人在成年后更倾向于生活在贫困地区。高度贫困地区的政策制定者可以采用创伤知情方法进行社区关怀和支持，这对于减轻缺陷观点和为 ACE 患者提供全面支持至关重要。
