Adverse Childhood Experiences among Adults in North Carolina, USA: Influences on Risk Factors for Poor Health across the Lifespan and Intergenerational Implications

Adam Hege, Erin Bouldin, Manan Roy, Maggie Bennett, Peyton Attaway and Kellie Reed-Ashcraft
Additional contact information
Adam Hege: Public Health Program, Department of Health and Exercise Science, Appalachian State University, Boone, NC 28608, USA
Erin Bouldin: Public Health Program, Department of Health and Exercise Science, Appalachian State University, Boone, NC 28608, USA
Manan Roy: Department of Nutrition and Healthcare Management, Appalachian State University, Boone, NC 28608, USA
Maggie Bennett: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
Peyton Attaway: Research Triangle Institute, Raleigh, NC 27616, USA
Kellie Reed-Ashcraft: Department of Social Work, Appalachian State University, Boone, NC 28608, USA

IJERPH, 2020, vol. 17, issue 22, 1-14

Abstract: Adverse childhood experiences (ACEs) are a critical determinant and predictor of health across the lifespan. The Appalachian region of the United States, particularly the central and southern portions, experiences worse health outcomes when compared to the rest of the nation. The current research sought to understand the cross-sectional relationships between ACEs, social determinants of health and other health risk factors in one southcentral Appalachian state. Researchers used the 2012 and 2014 North Carolina Behavioral Risk Factor Surveillance System (BRFSS) for analyses. An indicator variable of Appalachian county ( n = 29) was used to make comparisons against non-Appalachian counties ( n = 71). Analyses further examined the prevalence of ACEs in households with and without children across Appalachian and non-Appalachian regions, and the effects of experiencing four or more ACEs on health risk factors. There were no statistically significant differences between Appalachian and non-Appalachian counties in the prevalence of ACEs. However, compared with adults in households without children, those with children reported a higher percentage of ACEs. Reporting four or more ACEs was associated with higher prevalence of smoking (prevalence ratio [PR] = 1.56), heavy alcohol consumption (PR = 1.69), overweight/obesity (PR = 1.07), frequent mental distress (PR = 2.45), and food insecurity (PR = 1.58) in adjusted models and with fair or poor health only outside Appalachia (PR = 1.65). Residence in an Appalachian county was independently associated with higher prevalence of food insecurity (PR = 1.13). Developing programs and implementing policies aimed at reducing the impact of ACEs could improve social determinants of health, thereby helping to reduce health disparities.

Keywords: adverse childhood experiences (ACEs); social determinants of health; health disparities; Behavioral Risk Factor Surveillance System (BRFSS); North Carolina (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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