Adverse Childhood Experiences and Suboptimal Self-Rated Health in Adulthood: Exploring Effect Modification by Age, Sex and Race/Ethnicity.

IF 2.5 4区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American Journal of Health Promotion Pub Date : 2024-10-16 DOI:10.1177/08901171241293412

Olatokunbo Osibogun

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引用次数: 0

Abstract

Purpose: 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.

Design: Cross-sectional study.

Setting: United States.

Sample: 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.

Measures: 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.

Analysis: 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.

Conclusion: ACEs should be considered when creating health-promoting interventions to improve health.

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童年的不良经历与成年后的自我健康评价不佳：探索年龄、性别和种族/族裔对效果的修正。

目的：本研究调查了全国代表性人群中成年人的童年不良经历（ACE）与自评健康之间的关系是否会因年龄、性别或种族/民族而改变：设计：横断面研究：样本：美国从 2020 年和 2021 年行为风险因素监测系统中获得了 185 731 名（加权 N = 47 862 016）18 岁及以上人群的数据：ACE累积得分（范围：0-11）由11个关于18岁前童年情感虐待、身体虐待、性虐待和家庭功能障碍的问题计算得出，分为0（参考）、1、2、3或≥4。自评健康状况分为（优/很好/好[参考]）和次优（一般/差）两类：进行了多变量调整逻辑回归，以检验年龄、性别和种族/民族与 ACE 之间的相互作用。在对潜在的混杂因素进行调整后，除了 1 个 ACE 外（1 个 ACE：aOR:1.09；95% CI：1.00-1.20；2 个 ACE：1.16；1.03-1.30；3 个 ACE：1.17；1.03-1.32；≥4 个 ACE：1.39；1.26-1.53），ACE 数量越多，自评健康欠佳的几率就越高。ACE 与年龄之间存在明显的交互作用。与年龄较大的人群相比，年龄较小（18-24 岁）的人群与≥4 ACEs 的关联性最强。性别或种族没有影响：结论：在制定促进健康的干预措施以改善健康状况时，应考虑到 ACE。

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

American Journal of Health Promotion PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

4.40

自引率

3.70%

发文量

184

期刊介绍： The editorial goal of the American Journal of Health Promotion is to provide a forum for exchange among the many disciplines involved in health promotion and an interface between researchers and practitioners.