unit 2 - adverse childhood experiences (aces)

Question 1

what affects health at every stage of life?

Answer 1

family income, education, neighborhood resources, social capital, sleep, stress

Question 2

growing body of evidence

Answer 2

• early childhood experiences are tied to health throughout life > particularly in adulthood
• it is possible to turn vicious cycles into paths to health > early intervention
• effects of early childhood interventions are greatest for children who are at the greatest social and economic disadvantage, but children in all families benefit from early childhood programs

Question 3

a cycle of opportunity or obstacles

Answer 3

• at every stage of our lives, social advantage, or disadvantage - is linked to health: accumulates over time

Question 4

social and economic conditions: child development

Answer 4

• Early childhood experiences affect brain,
  cognitive, and behavioral development
• Social experiences in the first few years of life
  shape the development of infants and toddlers –
  adverse or favorable
• Parents’ social and economic resources can
  affect the quality and stability of their relationships
  with their infants > affecting child emotional
  development
• Maternal depression
• Language development

Question 5

children’s development shapes health throughout life

Answer 5

• Brain, cognitive, and behavioral development early in life are strongly
  linked to health outcomes later in life
• Cardiovascular disease and stroke
• Hypertension
• Diabetes
• Obesity What is the common element??
• Smoking
• Drug Use
• Depression

Question 6

adverse childhood experiences study

Answer 6

• Purpose: to explore the relationship of health risk behavior and disease
  in adulthood to the breadth of exposure to childhood emotional,
  physical, or sexual abuse, and household dysfunction
• Methods: Questionnaire mailed to 13,494 adults who completed a
  standardized medical evaluation at a large HMO (1995-1997)
• Conclusion: Strong, graded relationship between the breadth of
  exposure to abuse or household dysfunction during childhood and
  multiple risk factors for several of the leading causes of death

Question 7

disease conditions based on medical history

Answer 7

• History of ischemic heart
  disease
• Cancer
• Stroke
• Chronic bronchitis
• Emphysema (COPD)
• Diabetes
• Hepatitis or jaundice
• Skeletal fractures
• Self-rated health

Question 8

childhood exposure

Answer 8

• most prevalent was substance abuse
  in the household (25.6%)
• least prevalent was evidence of
  criminal behavior in the
  household (3.4%)
• more than half of respondnets experienced

Question 9

relationships between categories of childhood exposure

Answer 9

• for persons reporting any single category of exposure,the
  probability of exposure to any additional category ranged from
  65%-93%
• Significantly fewer categories of exposure were found among
  older persons, white or Asian persons, and college graduates
  (adjusting for age)

Question 10

results

Answer 10

• Both the prevalence and risk increased for smoking, severe obesity, physical
  inactivity, depressed mood, and suicide attempts as the number of childhood
  exposures increased
• When persons with 4 categories of exposure were compared to those with
  none, the odds ratios ranges from 1.3 for physical inactivity to 12.2 for
  suicide attempts
• As the number of childhood exposures increased, the prevalence and risk of
  the following also increased
• Alcoholism
• Use of illicit drugs, ≥ 50 intercourse partners, and sexually transmitted diseases

Question 11

updated BRFSS data

Answer 11

• 58% percent of respondents reported one or more ACES
• Most common: emotional abuse
• Females had significantly higher ACE scores compared to males
• Individuals who identified as Multiracial had a significantly higher ACE mean
  score than all other races/ethnicities
• Those making less than $15,000 per year had a significantly higher mean
  ACE score compared to all other categories* Individuals that earned a college degree had a significantly lower mean ACE
  score compared to all other groups
• Those in the unable to work category had a significantly higher mean ACE
  score than all other employment categories
• Bisexual individuals had a significantly higher prevalence of adversity in
  seven of eight categories
• Those residing in the West had a significantly higher mean ACE score
  compared to the other three regions