Osibogun Olatokunbo
Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA.
Am J Health Promot. 2025 Feb;39(2):244-252. doi: 10.1177/08901171241293412. Epub 2024 Oct 16.
This study examined whether the relationship between adverse childhood experiences (ACEs) and self-rated health among adults in a nationally representative population is modified by age, sex, or race/ethnicity.
Cross-sectional study.
United States.
Data from the 2020 and 2021 Behavioral Risk Factor Surveillance System were obtained from 185 731 (weighted N = 47 862 016) persons 18 years or older.
The ACE cumulative score (range: 0-11) was calculated using 11 questions about childhood emotional abuse, physical abuse, sexual abuse, and household dysfunction before age 18 and classified as 0 (reference), 1, 2, 3, or ≥4. Self-rated health was divided into (excellent/very good/good [reference]) and suboptimal (fair/poor) categories.
Multivariable-adjusted logistic regression was conducted to test for the interaction with age, sex, and race/ethnicity with ACEs. After adjustment for potential confounders, an increasing number of ACEs had statistically significantly higher odds of suboptimal self-rated health in a graded manner except for 1 ACE (1 ACE: aOR:1.09; 95% CI: 1.00-1.20, 2 ACEs: 1.16; 1.03-1.30, 3 ACEs: 1.17; 1.03-1.32 and ≥4 ACEs: 1.39; 1.26-1.53). There was a significant interaction between ACEs and age. Younger age (18-24 years) had the strongest association for ≥4 ACEs compared to the older age groups. There was no effect modification by sex or race.
ACEs should be considered when creating health-promoting interventions to improve health.
本研究探讨了在全国代表性人群中，不良童年经历（ACEs）与成年人自评健康之间的关系是否会因年龄、性别或种族/民族而有所不同。
横断面研究。
美国。
从2020年和2021年行为危险因素监测系统中获取了185731名（加权N = 47862016）18岁及以上人群的数据。
ACE累积得分（范围：0 - 11）通过11个关于18岁之前童年期情感虐待、身体虐待、性虐待和家庭功能障碍的问题计算得出，并分为0（参照组）、1、2、3或≥4。自评健康分为（优秀/非常好/良好[参照组]）和次优（一般/差）两类。
进行多变量调整的逻辑回归，以检验ACEs与年龄、性别和种族/民族之间的相互作用。在对潜在混杂因素进行调整后，除了1次ACE外，ACEs数量的增加与次优自评健康的几率在分级方式上具有统计学显著的更高关联（1次ACE：调整优势比[aOR]：1.09；95%置信区间[CI]：1.00 - 1.20，2次ACE：1.16；1.03 - 1.30，3次ACE：1.17；1.03 - 1.32，≥4次ACE：1.39；1.26 - 1.53）。ACEs与年龄之间存在显著的相互作用。与年龄较大的组相比，年龄较小（18 - 24岁）的人群中≥4次ACE的关联最强。性别或种族不存在效应修饰。
在制定促进健康的干预措施以改善健康状况时，应考虑ACEs。
