Measuring mortality and the burden of adult disease associated with adverse childhood experiences in England: A national survey

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dc.contributor.authorBellis, M. A., Hughes, K., Leckenby, N., Hardcastle, K. A., Perkins, C., & Lowey, H.
dc.date.accessioned2015-10-01T15:48:45Z
dc.date.available2015-10-01T15:48:45Z
dc.date.issued2014
dc.description.abstractBackground: ACE (adverse childhood experience) studies typically examine the links between childhood stressors and adult health harming behaviours. Using an enhanced ACE survey methodology, we examine impacts of ACEs on non-communicable diseases and incorporate a proxy measure of premature mortality in England. Methods: A nationally representative survey was undertaken (n = 3885, aged 18–69, April–July 2013). Socio-demographically controlled proportional hazards analyses examined the associations between the number of ACE categories (<18 years; e.g. child abuse and family dysfunction such as domestic violence) and cancer, diabetes, stroke, respiratory, liver/digestive and cardiovascular disease. Sibling (n = 6983) mortality was similarly analysed as a measure of premature mortality. Results: Of the total, 46.4% of respondents reported >1 and 8.3% >4 ACEs. Disease development was strongly associated with increased ACEs (e.g. hazard ratios, HR, 0 versus >4 ACEs; cancer, 2.38 (1.48–3.83); diabetes, 2.99 (1.90–4.72); stroke, 5.79 (2.43–13.80, all P, 0.001). Individuals with 4 ACEs (versus no ACEs) had a 2.76 times higher rate of developing any disease before age 70 years. Adjusted HR for mortality was strongly linked to ACEs (>4 versus 0 ACEs; HR, 1.97 (1.39–2.79), P, 0.001). Conclusions: Radically different life-course trajectories are associated with exposure to increased ACEs. Interventions to prevent ACEs are available but rarely implemented at scale. Treating the resulting health costs across the life course is unsustainable. (Author Abstract)en_US
dc.identifier.citationBellis, M. A., Hughes, K., Leckenby, N., Hardcastle, K. A., Perkins, C., & Lowey, H. (2014). Measuring mortality and the burden of adult disease associated with adverse childhood experiences in England: a national survey. Journal of public health, 37(3), 445-454.en_US
dc.identifier.urihttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC4552010/pdf/fdu065.pdf
dc.identifier.urihttp://hdl.handle.net/11212/2541
dc.language.isoenen_US
dc.publisherJournal of public healthen_US
dc.subjectInternational Resourcesen_US
dc.subjectUnited Kingdomen_US
dc.subjectresearchen_US
dc.subjectChild abuseen_US
dc.subjectlong term effectsen_US
dc.subjectmorbidity and mortalityen_US
dc.titleMeasuring mortality and the burden of adult disease associated with adverse childhood experiences in England: A national surveyen_US
dc.typeArticleen_US

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