Childhood residential mobility and multiple health risks during adolescence and adulthood - The hidden role of adverse childhood experiences
Childhood residential mobility and multiple health risks during adolescence and adulthood - The hidden role of adverse childhood experiences
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DOI：
10.1001/archpedi.159.12.1104
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发表时间：
2005-12-01
影响因子：
--
通讯作者：
Giles, WH
中科院分区：
文献类型：
--
作者：
Dong, MX;Anda, RF;Giles, WH
背景：纵观美国历史，美国社会的特点是高度的居住流动性。以前的数据表明流动性和增加的健康风险之间的关系，但这种关系可能会混淆未测量的不良童年经历（ACEs.Objectives：To examine the relationship of childhood residential mobility to health problems during adolescence and adult and to determine how much these apparent relationships may result from underlying ACEs.设计，设置，和参与者：对8116名成年人进行的回顾性队列研究，这些成年人完成了一项调查，包括儿童居住流动性，ACE（儿童期虐待、儿童期忽视和家庭功能障碍）和多种健康问题。主要结果指标：儿童搬家的次数和ACE的次数（ACE评分）与抑郁情绪、自杀未遂、酗酒、吸烟、过早性行为和少女怀孕的关系进行了评估。在调整人口统计学变量后，每个ACE的儿童期高居住流动性（>= 8次移动）的风险为1.7至3.1倍，并随着ACE的数量增加而增加。与从不搬家的受访者相比，儿童时期流动性高的受访者的健康风险几率从1.3（吸烟）到2.5（自杀）不等。然而，当ACE的数量进入多变量模型，流动性和健康问题之间的关系大大减少。结论：不良的童年经历与频繁的住宅流动性密切相关。此外，儿童流动性和各种健康风险之间的明显关系在很大程度上是由ACE解释的。因此，以前的研究表明，住宅流动性和负面结果之间的关系可能会混淆未测量的ACE。
Background: Throughout US history, US society has been characterized by its high degree of residential mobility. Previous data suggest a relationship between mobility and increased health risk, but this relationship might be confounded by unmeasured adverse childhood experiences (ACEs).Objectives: To examine the relationship of childhood residential mobility to health problems during adolescence and adulthood and to determine how much these apparent relationships may result from underlying ACEs.Design, Setting, and Participants: Retrospective cohort study of 8116 adults who completed a survey that included childhood residential mobility, ACEs (childhood abuse, childhood neglect, and household dysfunction), and multiple health problems.Main Outcome Measures: Number of childhood residential moves and number of ACEs (ACE score) were assessed for relationships to depressed affect, attempted suicide, alcoholism, smoking, early sexual initiation, and teenaged pregnancy.Results: After adjustment for demographic variables, the risk of high residential mobility during childhood ( >= 8 moves) was 1.7- to 3.1-fold for each ACE, and increased with the number of ACEs. Compared with respondents who never moved, the odds of health risk for respondents with high mobility during childhood ranged from 1.3 (for smoking) to 2.5 (for suicide). However, when the number of ACEs was entered into multivariate models, the relationship between mobility and health problems was greatly reduced.Conclusions: Adverse childhood experiences are strongly associated with frequent residential mobility. Moreover, the apparent relationship between childhood mobility and various health risks is largely explained by ACEs. Thus, previous studies showing a relationship between residential mobility and negative outcomes were likely confounded by unmeasured ACEs.