Adverse childhood experiences and preventive health care among rural US children: A cross-sectional examination of 2022 National Health Interview Survey data

IF 2.7 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Journal of Rural Health Pub Date : 2025-09-28 DOI:10.1111/jrh.70081

Mary Labuhn MPH, Andrew Williams MPH, PhD

{"title":"Adverse childhood experiences and preventive health care among rural US children: A cross-sectional examination of 2022 National Health Interview Survey data","authors":"Mary Labuhn MPH, Andrew Williams MPH, PhD","doi":"10.1111/jrh.70081","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Purpose</h3>\n \n <p>Rural-residing children have poor access to preventive health care due to geographic and socioeconomic issues, yet the role of adverse childhood experiences (ACEs) in preventive care for rural children has been understudied. It is hypothesized that among rural-residing children, those with ≥1 ACE will have lower utilization of preventive health care, with differences by sex.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Data for 425 (weighted n = 3,949,102) children (aged 9-17) residing in “nonmetropolitan” (2013 NCHS Urban-Rural Classification) were drawn from the 2022 National Health Interview Survey. Physician visit in the past 12 months (yes/no), dental visit in the past 12 months (yes/no), COVID-19, flu, and HPV vaccination (yes/no) were self-reported. Participants self-reported (yes/no) to 6 ACEs (high ACEs ≥1). Logistic regression estimated odds ratios and 95% confidence intervals for associations between ACEs and preventive health outcomes, adjusted for demographic and health care factors. This manuscript adheres to STROBE guidelines.</p>\n </section>\n \n <section>\n \n <h3> Findings</h3>\n \n <p>Children with ≥1 ACE were 81% more likely (OR = 1.81, 95% CI 1.04, 3.18) to receive a flu vaccination and 184% (OR = 2.84, 95% CI 1.66, 4.85) more likely to receive an HPV vaccination compared to children with 0 ACEs. No significant associations were found between ACEs and other preventive health care. Boys with ≥1 ACE had decreased odds (OR = 0.34, 95% CI 0.13, 0.94) of visiting a dentist, while girls with ≥1 ACE had increased odds (OR = 3.87, 95% CI 1.56, 9.60) of receiving an HPV vaccination.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Children with ≥1 ACE were more likely to receive a flu vaccination and HPV vaccination. The effect of ACEs on preventive health care may differ by sex among rural residents, yet additional research is warranted to inform prevention efforts in rural communities.</p>\n </section>\n </div>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"41 4","pages":""},"PeriodicalIF":2.7000,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jrh.70081","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Rural Health","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jrh.70081","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

Rural-residing children have poor access to preventive health care due to geographic and socioeconomic issues, yet the role of adverse childhood experiences (ACEs) in preventive care for rural children has been understudied. It is hypothesized that among rural-residing children, those with ≥1 ACE will have lower utilization of preventive health care, with differences by sex.

Methods

Data for 425 (weighted n = 3,949,102) children (aged 9-17) residing in “nonmetropolitan” (2013 NCHS Urban-Rural Classification) were drawn from the 2022 National Health Interview Survey. Physician visit in the past 12 months (yes/no), dental visit in the past 12 months (yes/no), COVID-19, flu, and HPV vaccination (yes/no) were self-reported. Participants self-reported (yes/no) to 6 ACEs (high ACEs ≥1). Logistic regression estimated odds ratios and 95% confidence intervals for associations between ACEs and preventive health outcomes, adjusted for demographic and health care factors. This manuscript adheres to STROBE guidelines.

Findings

Children with ≥1 ACE were 81% more likely (OR = 1.81, 95% CI 1.04, 3.18) to receive a flu vaccination and 184% (OR = 2.84, 95% CI 1.66, 4.85) more likely to receive an HPV vaccination compared to children with 0 ACEs. No significant associations were found between ACEs and other preventive health care. Boys with ≥1 ACE had decreased odds (OR = 0.34, 95% CI 0.13, 0.94) of visiting a dentist, while girls with ≥1 ACE had increased odds (OR = 3.87, 95% CI 1.56, 9.60) of receiving an HPV vaccination.

Conclusions

Children with ≥1 ACE were more likely to receive a flu vaccination and HPV vaccination. The effect of ACEs on preventive health care may differ by sex among rural residents, yet additional research is warranted to inform prevention efforts in rural communities.

Abstract Image

查看原文本刊更多论文

美国农村儿童的不良童年经历和预防性保健：对2022年全国健康访谈调查数据的横断面检查

目的由于地理和社会经济问题，农村儿童难以获得预防性保健，但不良童年经历（ace）在农村儿童预防性保健中的作用尚未得到充分研究。假设在农村儿童中，ACE≥1的儿童对预防性保健的利用率较低，且存在性别差异。方法从2022年全国健康访谈调查中抽取425名（加权n = 3,949,102）名居住在“非大都市”（2013年NCHS城乡分类）的儿童（9-17岁）的数据。自我报告过去12个月的医生就诊（是/否）、过去12个月的牙科就诊（是/否）、COVID-19、流感和HPV疫苗接种（是/否）。参与者自我报告（是/否）至6个ace（高ace≥1）。经人口统计学和卫生保健因素调整后，Logistic回归估计了ace与预防性健康结果之间的比值比和95%置信区间。本手稿遵循STROBE指南。与无ACE的儿童相比，ACE≥1的儿童接受流感疫苗接种的可能性增加81% (OR = 1.81, 95% CI 1.04, 3.18)， HPV疫苗接种的可能性增加184% （OR = 2.84, 95% CI 1.66, 4.85）。ace与其他预防性保健之间未发现显著关联。ACE≥1的男孩看牙医的几率降低（OR = 0.34, 95% CI 0.13, 0.94），而ACE≥1的女孩接受HPV疫苗接种的几率增加（OR = 3.87, 95% CI 1.56, 9.60）。结论：ACE≥1的儿童更有可能接种流感疫苗和HPV疫苗。在农村居民中，ace对预防保健的影响可能因性别而异，但需要进一步的研究来为农村社区的预防工作提供信息。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Rural Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.60

自引率

6.10%

发文量

审稿时长

>12 weeks

期刊介绍： The Journal of Rural Health, a quarterly journal published by the NRHA, offers a variety of original research relevant and important to rural health. Some examples include evaluations, case studies, and analyses related to health status and behavior, as well as to health work force, policy and access issues. Quantitative, qualitative and mixed methods studies are welcome. Highest priority is given to manuscripts that reflect scholarly quality, demonstrate methodological rigor, and emphasize practical implications. The journal also publishes articles with an international rural health perspective, commentaries, book reviews and letters.