Centers for Disease Control and Prevention National Center for Injury Prevention and Control, Atlanta, Georgia, USA
Ctr Dis Control, Atlanta, Georgia, USA.
Inj Prev. 2024 Oct 1;30(5):355-362. doi: 10.1136/ip-2024-045295.
Adverse childhood experiences (ACEs), suicide and overdose are linked across the life course and across generations and share common individual-, interpersonal-, community- and societal-level risk factors. The purpose of this review is to summarise the shared aetiology of these public health issues, synthesise evidence regarding potential community- and societal-level prevention strategies and discuss future research and practice directions.Growing evidence shows the potential for community- and societal-level programmes and policies, including higher minimum wage; expanded Medicaid eligibility; increased earned income tax credits, child tax credits and temporary assistance for needy families benefits; Paid Family Leave; greater availability of affordable housing and rental assistance; and increased participation in the Supplemental Nutrition Assistance Program (SNAP), to contribute to ACEs, suicide and overdose prevention. Considerations for future prevention efforts include (1) expanding the evidence base through rigorous research and evaluation; (2) assessing the implications of prevention strategies for equity; (3) incorporating a relational health perspective; (4) enhancing community capacity to implement, scale and sustain evidenced-informed prevention strategies; and (5) acknowledging that community- and societal-level prevention strategies are longer-term strategies.
不良的童年经历 (ACEs)、自杀和过量用药在整个生命过程中以及代际之间相互关联,并且具有共同的个体、人际、社区和社会层面的风险因素。本综述的目的是总结这些公共卫生问题的共同病因,综合有关潜在的社区和社会层面预防策略的证据,并讨论未来的研究和实践方向。越来越多的证据表明,包括提高最低工资、扩大医疗补助资格、增加劳动所得税收抵免、儿童税收抵免和贫困家庭临时援助福利、带薪家庭休假、增加负担得起的住房和租金援助的提供,以及增加参与补充营养援助计划(SNAP)等社区和社会层面的计划和政策,可能有助于预防 ACEs、自杀和过量用药。未来预防工作的考虑因素包括:(1) 通过严格的研究和评估扩大证据基础;(2) 评估预防策略对公平的影响;(3) 纳入关系健康视角;(4) 增强社区实施、扩大和维持基于证据的预防策略的能力;以及(5) 认识到社区和社会层面的预防策略是长期策略。