Adverse Childhood Experiences, Health-Related Quality of Life, and Chronic Disease Risks in Rural Areas of the United States
Date
2018
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Publisher
Journal of Environmental and Public Health
Abstract
Exposure to adverse childhood experiences (ACEs) is associated with increased odds of high-risk behaviors and adverse health
outcomes. This study examined whether ACE exposure among individuals living in rural areas of the United States is associated
with adult activity limitations, self-reported general poor health status, chronic diseases, and poor mental health.Data fromthe 2011
and 2012 Behavioral Risk Factor Surveillance System (BRFSS) (N=79,810) from nine states were used to calculate the prevalence of
ACEs in rural and urban areas. ACE scores were determined by summing 11 survey items. Multiple logistic regression was used to
examine the association between ACE scores and health outcomes, including self-reported general health status, chronic diseases,
and health-related quality of life. Approximately 55.4% of rural respondents aged ≥18 years reported at least one ACE and 14.7%
reported experiencing ≥4 ACEs in their childhood, compared to 59.5% of urban residents who reported at least one ACE and 15.5%
reporting ≥4 ACEs. After adjusting for sociodemographic covariates, compared to rural respondents who never reported an ACE,
rural respondentswho experienced ≥1ACEs had increased odds of reporting fair/poor general health, activity limitations, and heart
disease, which is consistent with previous studies.Theodds of experiencing a heart attack were higher for rural residents reporting 2
and ≥4 ACEs; the odds of diabetes were higher for those with 3 ACEs; and the odds of ever having asthma or poormental health was
higher for those with ≥3 ACEs. Although individuals in rural areas are less likely to experience ACEs, over half of rural respondents
reported experiencing an ACE in childhood. Programs aimed at preventing ACEs, including child maltreatment, can benefit rural
areas by reducing adult morbidity and increasing quality of life.
Description
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Keywords
Adverse Childhood Experiences (ACE), health effects, quality of life, long term effects
Citation
Chanlongbutra, A., Singh, G. K., & Mueller, C. D. (2018). Adverse Childhood Experiences, Health‐Related Quality of Life, and Chronic Disease Risks in Rural Areas of the United States. Journal of Environmental and Public Health, 2018.