NDLI: Separate and cumulative effects of adverse childhood experiences in predicting adult health and health care utilization.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Chartier, Mariette J. Walker, John R. Naimark, Barbara
Spatial Coverage	Ontario
Description	Country affiliation: Canada Author Affiliation: Chartier MJ ( Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.)
Abstract	OBJECTIVES: Objectives of this population-based study were: (1) to examine the relative contribution of childhood abuse and other adverse childhood experiences to poor adult health and increased health care utilization and (2) to examine the cumulative effects of adverse childhood experiences on adult health and health care utilization. METHODS: Data from the Ontario Health Survey, a representative population sample (n=9,953) of respondents aged 15 years and older, were analyzed using logistic regression. Adverse childhood experiences examined were childhood physical and sexual abuse, parental marital conflict, poor parent-child relationship, low parental education and parental psychopathology. RESULTS: Most (72%) respondents reported at least one adverse childhood experience and a considerable proportion of respondents (37%) reported two or more of these experiences. In examining the bivariate models, childhood physical and sexual abuse had a stronger influence than other types of adverse childhood experiences. With the addition of other adverse childhood experiences in the model, the odds ratios for childhood abuse were attenuated but remained statistically significant for most health outcomes. This suggests that childhood abuse may have a unique adverse influence on the development of poor adult health. When an aggregate variable was created to explore the cumulative effects of adverse childhood experience, the odds were increased, with each additional experience, for reporting multiple health problems [odds ratio (OR): 1.22], poor self-rated health (OR: 1.18), pain (OR: 1.24), disability (OR: 1.24), general practitioner use (OR: 1.12), emergency room use (OR: 1.29) and health professional use (OR: 1.19). CONCLUSIONS: This study suggests that childhood abuse and other adverse childhood experiences are overlapping risk factors for long-term adult health problems and that the accumulation of these adverse experiences increases the risk of poor adult health. PRACTICE IMPLICATIONS: This study highlights the importance of the many adverse childhood experiences influencing long-term health. In practice, childhood abuse is often difficult to identify as families tend to keep it hidden and reported cases represent only a small percentage of the actual cases. Assessments and interventions which focus on improving socio-economic status, strengthening marital and parent-child relationships, and supporting parents with mental health issues are less threatening for families than assessing their experiences with abuse and neglect and are more likely to be effective in identifying and supporting at-risk families.
File Format	HTM / HTML
ISSN	01452134
Issue Number	6
Volume Number	34
e-ISSN	18737757
Journal	Child Abuse & Neglect
Language	English
Publisher	Elsevier
Publisher Date	2010-06-01
Publisher Place	Great Britain (UK)
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Pediatrics Adult Survivors Of Child Abuse Psychology Family Conflict Health Services Utilization Adolescent Adult Aged Aged, 80 And Over Child, Preschool Female Forecasting Health Status Health Surveys Humans Logistic Models Male Middle Aged Ontario Risk Factors Young Adult Journal Article Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Developmental and Educational Psychology Social Work Psychiatry and Mental Health Pediatrics, Perinatology and Child Health

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1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
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