Pathways from childhood abuse and other adversities to adult health risks: The role of adult socioeconomic conditions
Pathways from childhood abuse and other adversities to adult health risks: The role of adult socioeconomic conditions
复制标题
DOI：
10.1016/j.chiabu.2015.05.013
复制
发表时间：
2016-01-01
影响因子：
4.8
通讯作者：
Maguire-Jack, Kathryn
中科院分区：
文献类型：
--
作者：
Font, Sarah A.;Maguire-Jack, Kathryn
不良童年经历（ACE），包括虐待儿童，与成年后的不良健康结果有关。解释这些关系的机制还不太清楚。这项研究评估了ACE和健康风险的关联是否由成人的社会经济条件介导，以及这些途径是否与其他类型的逆境不同。使用行为风险因素监测系统2012年调查（N = 29，229），我们采用结构方程模型来（1）估计ACE的数量和类型与五种健康风险（抑郁、肥胖、吸烟、酗酒和自我报告的次优健康）的关联;以及（2）评估成年人的社会经济条件（婚姻、离婚和分居）、教育程度、收入和保险状况是否介导了这些关联。研究结果表明ACE和健康风险之间存在直接和间接的关联。在高数量的ACE中，ACE数量与成人健康风险之间的关联有15-20%归因于社会经济条件。协会的三个ACE（暴露于家庭暴力，父母离婚，并与一个人谁是监禁）与健康风险几乎完全解释了成年后的社会经济条件。然而，儿童的身体，情感和性虐待显着相关的几个成年人的健康风险，超出了其他逆境的影响，和社会经济条件只解释了这些协会的一小部分。这些研究结果表明，成人健康状况不佳的途径因ACE类型而异，儿童虐待比其他逆境更有可能产生直接影响。(C)2015爱思唯尔有限公司版权所有。
Adverse childhood experiences (ACEs), including child abuse, have been linked with poor health outcomes in adulthood. The mechanisms that explain these relations are less understood. This study assesses whether associations of ACEs and health risks are mediated by adult socioeconomic conditions, and whether these pathways are different for maltreatment than for other types of adversities. Using the Behavioral Risk Factor Surveillance System 2012 survey (N = 29,229), we employ structural equation modeling to (1) estimate associations of the number and type of ACEs with five health risks depression, obesity, tobacco use, binge drinking, and self-reported sub-optimal health; and (2) assess whether adult socioeconomic conditions marriage, divorce and separation, educational attainment, income and insurance status mediate those associations. Findings suggest both direct and indirect associations between ACEs and health risks. At high numbers of ACEs, 15-20% of the association between number of ACEs and adult health risks was attributable to socioeconomic conditions. Associations of three ACEs (exposure to domestic violence, parental divorce, and residing with a person who was incarcerated) with health risks were nearly entirely explained by socioeconomic conditions in adulthood. However, child physical, emotional, and sexual abuse were significantly associated with several adult health risks, beyond the effects of other adversities, and socioeconomic conditions explained only a small portion of these associations. These findings suggest that the pathways to poor adult health differ by types of ACEs, and that childhood abuse is more likely than other adversities to have a direct impact. (C) 2015 Elsevier Ltd. All rights reserved.