In the Journals

More than 60% of US adults experienced childhood adversity

Well over half of American adults have experienced at least one adverse childhood experience in their lifetime, and nearly one-quarter reported three or more of these experiences, according to research published in JAMA Pediatrics. The CDC says that these events, also known as ACEs, are linked to risky health behaviors, chronic health conditions, low life potential and early mortality.

“The foundation for lifelong health, well-being and even prosperity is built in childhood,” Melissa T. Merrick, PhD, a behavioral scientist from the division of violence prevention at the CDC, and colleagues wrote. “Positive experiences strengthen developing biological systems, whereas childhood adversity can increase morbidity and mortality and have an effect on access to life opportunities.”

Merrick and colleagues sought to update the prevalence of ACEs in the United States. Data were collected from adults residing in 23 states between Jan. 1, 2011, and Dec. 31, 2014. ACE scores ranged from 1.00 to 8.00, with higher scores equating to higher exposures.

Of the 214,157 noninstitutionalized adults in the study, 61.55% experienced least one ACE, and 24.64% had three or more.

The researchers said that those with higher rates of ACEs were frequently black (average score = 1.69; 95% CI, 1.62-1.76), Hispanic (average score = 1.80; 95% CI, 1.70-1.91) or multiracial (average score = 2.52; 95% CI, 2.36-2.67).

Additionally, higher scores were reported for those who had not obtained a high school education (average score = 1.97; 95% CI, 1.88-2.05), who earned less than $15,000 annually (average score = 2.16; 95% CI, 2.09-2.23), who were unemployed (average score = 2.30; 95% CI, 2.21-2.38) or who could not work (average score = 2.33; 95% CI, 2.25-2.42).

Merrick and colleagues also said that sexual minorities had high rates of ACEs, with adults identifying as gay or lesbian reporting an average score of 2.19 (95% CI, 1.95-2.43), and bisexual adults reporting an average score of 3.14 (95% CI, 2.82-3.46).

According to the researchers, the most commonly reported ACEs experienced by adults during their childhoods were emotional abuse (34.42%; 95% CI, 33.81%-35.03%), parental separation or divorce (27.63%; 95% CI, 27.02%-28.24%) and substance abuse within the home (27.56%; 95% CI, 27%-28.14%).

“Findings reveal that ACEs are prevalent across all demographic characteristics, yet some populations experience a greater, unequal burden of such exposure,” Merrick and colleagues wrote. “Identifying such inequities provides important information about the conditions in which children of adults with high ACEs are growing up and the subsequent effects of ACE exposure, including opioid use and misuse, on future generations.”

The researchers added that the variation in ACEs among the groups represented in the study backs previous findings that both social and structural characteristics contribute to ACE exposure, and that these events may create inequities in the health, social well-being and economic outcomes of an individual and future generations. – by Katherine Bortz

Resource:

CDC: Violence Prevention - About Adverse Childhood Experiences. https://www.cdc.gov/violenceprevention/acestudy/about_ace.html. Accessed September 17, 2018.

Disclosures: The authors report no relevant financial disclosures.

Well over half of American adults have experienced at least one adverse childhood experience in their lifetime, and nearly one-quarter reported three or more of these experiences, according to research published in JAMA Pediatrics. The CDC says that these events, also known as ACEs, are linked to risky health behaviors, chronic health conditions, low life potential and early mortality.

“The foundation for lifelong health, well-being and even prosperity is built in childhood,” Melissa T. Merrick, PhD, a behavioral scientist from the division of violence prevention at the CDC, and colleagues wrote. “Positive experiences strengthen developing biological systems, whereas childhood adversity can increase morbidity and mortality and have an effect on access to life opportunities.”

Merrick and colleagues sought to update the prevalence of ACEs in the United States. Data were collected from adults residing in 23 states between Jan. 1, 2011, and Dec. 31, 2014. ACE scores ranged from 1.00 to 8.00, with higher scores equating to higher exposures.

Of the 214,157 noninstitutionalized adults in the study, 61.55% experienced least one ACE, and 24.64% had three or more.

The researchers said that those with higher rates of ACEs were frequently black (average score = 1.69; 95% CI, 1.62-1.76), Hispanic (average score = 1.80; 95% CI, 1.70-1.91) or multiracial (average score = 2.52; 95% CI, 2.36-2.67).

Additionally, higher scores were reported for those who had not obtained a high school education (average score = 1.97; 95% CI, 1.88-2.05), who earned less than $15,000 annually (average score = 2.16; 95% CI, 2.09-2.23), who were unemployed (average score = 2.30; 95% CI, 2.21-2.38) or who could not work (average score = 2.33; 95% CI, 2.25-2.42).

Merrick and colleagues also said that sexual minorities had high rates of ACEs, with adults identifying as gay or lesbian reporting an average score of 2.19 (95% CI, 1.95-2.43), and bisexual adults reporting an average score of 3.14 (95% CI, 2.82-3.46).

According to the researchers, the most commonly reported ACEs experienced by adults during their childhoods were emotional abuse (34.42%; 95% CI, 33.81%-35.03%), parental separation or divorce (27.63%; 95% CI, 27.02%-28.24%) and substance abuse within the home (27.56%; 95% CI, 27%-28.14%).

“Findings reveal that ACEs are prevalent across all demographic characteristics, yet some populations experience a greater, unequal burden of such exposure,” Merrick and colleagues wrote. “Identifying such inequities provides important information about the conditions in which children of adults with high ACEs are growing up and the subsequent effects of ACE exposure, including opioid use and misuse, on future generations.”

The researchers added that the variation in ACEs among the groups represented in the study backs previous findings that both social and structural characteristics contribute to ACE exposure, and that these events may create inequities in the health, social well-being and economic outcomes of an individual and future generations. – by Katherine Bortz

Resource:

CDC: Violence Prevention - About Adverse Childhood Experiences. https://www.cdc.gov/violenceprevention/acestudy/about_ace.html. Accessed September 17, 2018.

Disclosures: The authors report no relevant financial disclosures.