Pereira Nicole, Zhu Xi
Fielding School of Public Health, University of California, Los Angeles, USA.
SSM Popul Health. 2025 Apr 11;30:101802. doi: 10.1016/j.ssmph.2025.101802. eCollection 2025 Jun.
Although childhood adversity's long-term effects on health are well recognized, few studies examine how community-level conditions shape the relationships between adverse childhood experiences (ACEs) and social risk and health outcomes in adulthood. Understanding these relationships can inform targeted, place-based interventions to improve health and social risk outcomes decades after ACEs exposure. This study explored how neighborhood socioeconomic contexts influence the relationships between childhood adversity and adulthood social risk and health outcomes. Using data from the 2021 California Health Interview Survey (CHIS), we analyzed a sample of 18,612 adults, representative of California's adult population. The Karlson-Holm-Breen (KHB) method decomposed childhood adversity's effects into direct and indirect effects mediated by neighborhood socioeconomic contexts in adulthood. Findings indicated higher ACE scores were associated with increased housing and food insecurity, and poorer self-rated health, particularly among individuals with four or more ACEs. The neighborhood socioeconomic context mediated a small but significant portion of the relationship between ACEs and the outcomes. Policy initiatives addressing ACEs should consider the importance of neighborhood contexts in addressing social risk and health outcomes.
尽管童年逆境对健康的长期影响已得到充分认识，但很少有研究探讨社区层面的状况如何塑造童年不良经历（ACEs）与成年期社会风险及健康结果之间的关系。了解这些关系可为有针对性的、基于地点的干预措施提供信息，以改善ACEs暴露数十年后的健康和社会风险结果。本研究探讨了邻里社会经济背景如何影响童年逆境与成年期社会风险及健康结果之间的关系。利用2021年加利福尼亚健康访谈调查（CHIS）的数据，我们分析了18612名成年人的样本，该样本代表了加利福尼亚的成年人口。卡尔森-霍尔姆-布林（KHB）方法将童年逆境的影响分解为成年期邻里社会经济背景介导的直接和间接影响。研究结果表明，较高的ACE分数与住房和粮食不安全增加以及自我评估健康状况较差有关，尤其是在有四项或更多ACEs的个体中。邻里社会经济背景介导了ACEs与结果之间关系的一小部分但显著的部分。应对ACEs的政策举措应考虑邻里背景在解决社会风险和健康结果方面的重要性。
