Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Health and Quality of Life Outcomes
Published in: Health and Quality of Life Outcomes 1/2015

Open Access 01-12-2015 | Research

Adverse childhood experiences and health-related quality of life in adulthood: revelations from a community needs assessment

Published in: Health and Quality of Life Outcomes | Issue 1/2015

Login to get access

Abstract

Background

Adverse childhood experiences (ACE) have been previously linked to quality of life, health conditions, and life expectancy in adulthood. Less is known about the potential mechanisms which mediate these associations. This study examined how ACE influences adult health-related quality of life (HRQoL) in a low-income community in Florida.

Methods

A community-based participatory needs assessment was conducted from November 2013 to March 2014 with 201 residents of Tampa, Florida, USA. HRQoL was measured by an excessive number of unhealthy days experienced during the previous 30-day window. Mediation analyses for dichotomous outcomes were conducted with logistic regression. Bootstrapped confidence intervals were generated for both total and specific indirect effects.

Results

Most participants reported ‘good to excellent health’ (76 %) and about a fourth reported ‘fair to poor health’ (24 %). The mean of total unhealthy days was 9 days per month (SD ±10.5). Controlling for demographic and neighborhood covariates, excessive unhealthy days was associated with ACE (AOR = 1.23; 95 % CI: 1.06, 1.43), perceived stress (AOR = 1.07; 95 % CI: 1.03, 1.10), and sleep disturbance (AOR = 8.86; 3.61, 21.77). Mediated effects were significant for stress (β = 0.08) and sleep disturbances (β = 0.11) as they related to  the relationship between ACE and excessive unhealthy days.

Conclusion

ACE is linked to adult HRQoL. Stress and sleep disturbances may represent later consequences of childhood adversity that modulate adult quality of life.
Appendix
Available only for authorised users
Literature
1.
CDC. CDC Health Disparities and Inequalities Report - United States, 2011. Morb Mortal Wkly Rep. 2011;60:1–114.
2.
Truman BI, Smith KC, Roy K, Chen Z, Moonesinghe R, Zhu J, et al. Rationale for regular reporting on health disparities and inequalities - United States. MMWR Surveill Summ. 2011;60(Suppl):3–10.PubMed
3.
4.
CDC. Adverse childhood experiences reported by adults -- five states, 2009. MMWR Morb Mortal Wkly Rep. 2010;59(49):1609–13.
5.
Felitti VJ, Anda RF. The relationship of adverse childhood experiences to adult medical disease, psychiatric disorders, and sexual behavior: implications for healthcare. In: Lanius RA, Vermetten E, Pain C, editors. The Impact of Early Life Trauma on Health Child and Adolescent Psychiatry and Mental and Disease: The Hidden Epidemic. New York: Cambridge University Press; 2010. p. 77–87.
6.
Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med. 1998;14(4):245–58.PubMedCrossRef
7.
8.
9.
Anda RF, Croft JB, Felitti VJ, Nordenberg D, Giles WH, Williamson DF, et al. Adverse childhood experiences and smoking during adolescence and adulthood. JAMA. 1999;282(17):1652–8.PubMedCrossRef
10.
11.
12.
Dube SR, Anda RF, Felitti VJ, Chapman DP, Williamson DF, Giles WH. Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span: findings from the Adverse Childhood Experiences Study. JAMA. 2001;286(24):3089–96.PubMedCrossRef
13.
Dube SR, Felitti VJ, Dong M, Giles WH, Anda RF. The impact of adverse childhood experiences on health problems: evidence from four birth cohorts dating back to 1900. Prev Med. 2003;37(3):268–77.PubMedCrossRef
14.
Dube SR, Cook ML, Edwards VJ. Health-related outcomes of adverse childhood experiences in Texas, 2002. Prev Chronic Dis. 2010;7(3):A52. doi:A52 [pii].PubMedCentralPubMed
15.
Loria AS, Ho DH, Pollock JS. A mechanistic look at the effects of adversity early in life on cardiovascular disease risk during adulthood. Acta Physiol (Oxf). 2013. doi:10.​1111/​apha.​12189.
16.
Salihu HM, August EM, Alio AP, Jeffers D, Austin D, Berry E. Community-academic partnerships to reduce black-white disparities in infant mortality in Florida. Prog Community Health Partnersh. 2011;5(1):53–66. doi:10.​1353/​cpr.​2011.​0009.PubMedCrossRef
17.
Salihu HM, August EM, Mbah AK, Alio AP, de Cuba 2nd R, Jaward FM, et al. Effectiveness of a federal healthy start program in reducing the impact of particulate air pollutants on feto-infant morbidity outcomes. Matern Child Health J. 2012;16(8):1602–11. doi:10.​1007/​s10995-011-0854-1.PubMedCrossRef
18.
Howard KS, Brooks-Gunn J. The role of home-visiting programs in preventing child abuse and neglect. Future Child. 2009;19(2):119–46.PubMedCrossRef
19.
Jevitt C, Zapata L, Harrington M, Berry E. Screening for perinatal depression with limited psychiatric resources. J Am Psychiatr Nurses Assoc. 2006;11:359–63.CrossRef
20.
21.
22.
Hornik J, Ellis S. Makhon le-mehkar asakim b-Y. Strategies to secure compliance for a Mall intercept interview. Tel Aviv: Israel Institute of Business Research; 1986.
23.
Andreasen AR. Academy for Educational D. Marketing research that won't break the bank : a practical guide to getting the information you need. San Francisco: Jossey-Bass; 2002.
24.
Hlady WG, Quenemoen LE, Armenia-Cope RR, Hurt KJ, Malilay J, Noji EK, et al. Use of a modified cluster sampling method to perform rapid needs assessment after Hurricane Andrew. Ann Emerg Med. 1994;23(4):719–25.PubMedCrossRef
25.
Braveman P, Barclay C. Health disparities beginning in childhood: a life-course perspective. Pediatrics. 2009;124:163–75.CrossRef
26.
27.
Lu MC, Halfon N. Racial and ethnic disparities in birth outcomes: a life-course perspective. Matern Child Health J. 2003;7(1):13–30.PubMedCrossRef
28.
29.
30.
Taylor VR. Measuring healthy days population assessment of health-related quality of life. Atlanta, Ga.: U.S. Dept. of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Adult and Community Health; 2000.
31.
CDC. Self-reported frequent mental distress among adults--United States, 1993–1996. MMWR Morb Mortal Wkly Rep. 1998;47(16):326–31.
32.
CDC. Frequently Asked Questions: Which cutpoints can I use to look at Frequent Mental Distress or Frequent Physical Distress? National Center for Chronic Disease Prevention and Health Promotion. Atlanta, Georgia: Division of Population Health; 2011. http://​www.​cdc.​gov/​hrqol/​faqs.​htm#10. Accessed 07/21/2014.
33.
Mentoring program enhances CM training. Healthcare Benchmarks Qual Improv. 2009;16(9):99–102.
34.
Hillis SD, Anda RF, Dube SR, Felitti VJ, Marchbanks PA, Marks JS. The association between adverse childhood experiences and adolescent pregnancy, long-term psychosocial consequences, and fetal death. Pediatrics. 2004;113(2):320–7.PubMedCrossRef
35.
36.
Arday DR, Tomar SL, Nelson DE, Merritt RK, Schooley MW, Mowery P. State smoking prevalence estimates: a comparison of the Behavioral Risk Factor Surveillance System and current population surveys. Am J Public Health. 1997;87(10):1665–9.PubMedCentralPubMedCrossRef
37.
Brener ND, Billy JO, Grady WR. Assessment of factors affecting the validity of self-reported health-risk behavior among adolescents: evidence from the scientific literature. J Adolesc Health. 2003;33(6):436–57.PubMedCrossRef
38.
39.
Thompson FE, Kipnis V, Subar AF, Krebs-Smith SM, Kahle LL, Midthune D, et al. Evaluation of 2 brief instruments and a food-frequency questionnaire to estimate daily number of servings of fruit and vegetables. Am J Clin Nutr. 2000;71(6):1503–10.PubMed
40.
Cohen S, Williamson G. Perceived stress in a probability sample of the United States. In: Spacapan S, Oskamp S, editors. The social psychology of health: Claremont Symposium on applied social psychology. Newbury Park, CA: Sage; 1988. p. 31–67.
41.
42.
43.
Steptoe A, Feldman PJ. Neighborhood problems as sources of chronic stress: development of a measure of neighborhood problems, and associations with socioeconomic status and health. Ann Behav Med. 2001;23(3):177–85.PubMedCrossRef
44.
Cagney KA, Browning CR. Exploring neighborhood-level variation in asthma and other respiratory diseases: the contribution of neighborhood social context. J Gen Intern Med. 2004;19(3):229–36.PubMedCentralPubMedCrossRef
45.
46.
47.
Preacher KJ, Hayes AF. SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behav Res Methods Instrum Comput. 2004;36(4):717–31.PubMedCrossRef
48.
Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986;51(6):1173–82.PubMedCrossRef
49.
50.
Hayes AF, Preacher KJ. Statistical mediation analysis with a multicategorical independent variable. The British journal of mathematical and statistical psychology. 2013. doi:10.​1111/​bmsp.​12028.
51.
Preacher KJ, Hayes AF. Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods. 2008;40(3):879–91.PubMedCrossRef
52.
53.
Leung MW, Yen IH, Minkler M. Community based participatory research: a promising approach for increasing epidemiology's relevance in the 21st century. Int J Epidemiol. 2004;33(3):499–506. doi:10.​1093/​ije/​dyh010.PubMedCrossRef
Metadata
Title
Adverse childhood experiences and health-related quality of life in adulthood: revelations from a community needs assessment
Publication date
01-12-2015
Published in
Health and Quality of Life Outcomes / Issue 1/2015
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/s12955-015-0323-4

Other articles of this Issue 1/2015

Health and Quality of Life Outcomes 1/2015 Go to the issue

Research

Factors associated with the life satisfaction amongst the rural elderly in Odisha, India

Research Article

Quantifying the importance of disease burden on perceived general health and depressive symptoms in patients within the Mayo Clinic Biobank

Research

Psychometric evaluation of the Mental Health Continuum-Short Form (MHC-SF) in Chinese adolescents – a methodological study

Research

Health-related quality of life of the rural-China left-behind children or adolescents and influential factors: a cross-sectional study

Research

Multimorbidity and functional decline in community-dwelling adults: a systematic review

Research Article

Predictors of health-related quality of life in patients with irritable bowel syndrome. A cross-sectional study in Norway