Healthcare and economic burden of adverse childhood experiences in Lahore, Pakistan

IF 2.3 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health Pub Date : 2024-09-20 DOI:10.1016/j.cegh.2024.101772

Rehan Shakeel, Muhammed Navid Tahir, Nauman Ali Ch, Assia Riaz

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Abstract

Objectives

Strong evidence links ACEs to adverse health outcomes, such as an increased risk of developing many chronic diseases. This study aimed to find the association between exposure to adverse childhood experiences (ACEs) and chronic health diseases and their healthcare and economic burdens in Lahore city.

Methods

The Study involved 385 participants from Lahore, Pakistan. Eligible participants who were 18 or older and below 18 years old were excluded. A cross-sectional study was conducted and the sample was collected using a stratified random sampling method. Cross-tabulation and Chi-Square tests were conducted to examine the relationship between exposure to ACEs and the outcomes of chronic diseases. Risk profiles including relative risk, attributable risk, and population attributable risk were calculated to determine the healthcare burden. The economic burden was calculated using DALYs and healthcare costs.

Results

The sample had a 59.8 % male predominance, and the average age was 29. 67 % of participants had at least one ACE-related chronic disease such as anxiety, depression, and stroke. A significant association was found between them (p < 0.05). Due to ACEs, study participants lost 1388 years of a healthy life. At the same time, ACE-related healthcare costs were roughly 4200 million PKR (15.14 million USD).

Conclusion

The results revealed an elevated risk of chronic health outcomes connected with experiencing one or more ACEs. Addressing ACEs may improve health, reduce healthcare expenditures, and increase resilience.

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巴基斯坦拉合尔儿童不良经历造成的医疗保健和经济负担

目的大量证据表明，ACE 与不良健康后果有关，如增加罹患多种慢性疾病的风险。本研究旨在发现拉合尔市童年不良经历（ACEs）与慢性疾病及其医疗和经济负担之间的关联。符合条件的参与者年龄在 18 岁或 18 岁以上，未满 18 岁者除外。研究采用分层随机抽样法收集样本，进行横断面研究。研究人员通过交叉表和 Chi-Square 检验来检验暴露于 ACE 与慢性疾病结果之间的关系。计算风险概况，包括相对风险、可归因风险和人群可归因风险，以确定医疗负担。经济负担则通过残疾调整生命年和医疗成本计算得出。67%的参与者至少患有一种与 ACE 相关的慢性疾病，如焦虑、抑郁和中风。研究发现，这些疾病之间存在明显的关联（p < 0.05）。由于 ACE，研究参与者失去了 1388 年的健康生活。同时，与 ACE 相关的医疗费用约为 4.2 亿巴基斯坦卢比（1514 万美元）。解决 ACE 问题可改善健康状况、减少医疗支出并提高复原力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Epidemiology and Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

4.60

自引率

7.70%

发文量

218

审稿时长

66 days

期刊介绍： Clinical Epidemiology and Global Health (CEGH) is a multidisciplinary journal and it is published four times (March, June, September, December) a year. The mandate of CEGH is to promote articles on clinical epidemiology with focus on developing countries in the context of global health. We also accept articles from other countries. It publishes original research work across all disciplines of medicine and allied sciences, related to clinical epidemiology and global health. The journal publishes Original articles, Review articles, Evidence Summaries, Letters to the Editor. All articles published in CEGH are peer-reviewed and published online for immediate access and citation.