Disability and Exposure to High Levels of Adverse Childhood Experiences: Effect on Health and Risk Behavior.
Disability and Exposure to High Levels of Adverse Childhood Experiences: Effect on Health and Risk Behavior.
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DOI：
10.18043/ncm.77.1.30
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发表时间：
2016-01-01
影响因子：
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通讯作者：
Simmons, Jacqueline
中科院分区：
文献类型：
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作者：
Austin, Anna;Herrick, Harry;Simmons, Jacqueline
背景：残疾人之间的健康差距以前已经记录在案。然而，很少有研究具体到不良的童年经历（ACE）在这一人群中，ACE暴露如何影响健康outcome.METHODS：从2012年北卡罗来纳州行为风险因素监测系统（BRFSS）调查的数据进行了分析，比较成人与非残疾和高ACE暴露（3-8 ACE）之间的ACE的患病率。调整后的风险比的健康风险和残疾状态的健康状况不佳，计算使用预测marginals.RESULTS：残疾人（36.5%）比那些没有残疾的人（19.6%）报告高ACE暴露的百分比较高。在ACE暴露率高的人群中，残疾人更有可能报告几种ACE类别，特别是儿童期性虐待。在调整分析中，残疾人吸烟的风险增加（相对风险[RR] = 1.29; 95% CI，1.10-1.51），身体健康状况差（RR = 4.34; 95%CI，3.08-6.11），心理健康状况差（RR = 4.69; 95%CI，3.19-6.87），和医生诊断的抑郁症（RR = 2.16; 95% CI，1.82-2.56）。局限性：从联邦调查局的调查中得出的残疾定义不允许将残疾人按照身体残疾与精神或情感残疾进行分类。此外，我们无法确定ACE暴露的时间与残疾onset.CONCLUSIONS：更好地了解ACE和残疾之间的生命历程协会和接触到多种类型的儿童期逆境对残疾和健康的影响是必要的通知研究和服务，具体到这个弱势群体。
BACKGROUND: Health disparities among persons with disabilities have been previously documented. However, there is little research specific to adverse childhood experiences (ACEs) in this population and how ACE exposure affects health outcomes in adulthood.METHODS: Data from the 2012 North Carolina Behavioral Risk Factor Surveillance System (BRFSS) survey were analyzed to compare the prevalence of ACEs between adults with and without disabilities and high ACE exposure (3-8 ACEs). Adjusted risk ratios of health risks and perceived poor health by disability status were calculated using predicted marginals.RESULTS: A higher percentage of persons with disabilities (36.5%) than those without disabilities (19.6%) reported high ACE exposure. Among those with high ACE exposure, persons with disabilities were more likely to report several ACE categories, particularly childhood sexual abuse. In adjusted analyses, persons with disabilities had an increased risk of smoking (relative risk [RR] = 1.29; 95% CI, 1.10-1.51), poor physical health (RR = 4.34; 95% CI, 3.08-6.11), poor mental health (RR = 4.69; 95% CI, 3.19-6.87), and doctor-diagnosed depression (RR = 2.16; 95% CI, 1.82-2.56) compared to persons without disabilities.LIMITATIONS: The definition of disability derived from the BRFSS survey does not allow for those with disabilities to be categorized according to physical disabilities versus mental or emotional disabilities. In addition, we were unable to determine the timing of ACE exposure in relation to disability onset.CONCLUSIONS: A better understanding of the life course associations between ACEs and disability and the impact of exposure to multiple types of childhood adversity on disability and health is needed to inform research and services specific to this vulnerable population.