National household survey of adverse childhood experiences and their relationship with resilience to health-harming behaviors in England

BMC Medicine

Research Article

Helen Lowey¹  Karen Hughes²  Mark A Bellis³  Nicola Leckenby⁴  Clare Perkins⁵ 

[1]Blackburn with Darwen Borough Council, Specialist Public Health Directorate, 6th floor, 10 Duke Street, BB2 1DH, Blackburn, UK

[2]Centre for Public Health, World Health Organization Collaborating Centre for Violence Prevention, Liverpool John Moores University, 15-21 Webster Street, L3 2ET, Liverpool, UK

[3]Centre for Public Health, World Health Organization Collaborating Centre for Violence Prevention, Liverpool John Moores University, 15-21 Webster Street, L3 2ET, Liverpool, UK

[4]Public Health Wales, Hadyn Ellis Building, Maindy Road, CF24 4HQ, Cardiff, UK

[5]Department of Academic Neonatal Medicine, Chelsea and Westminster Campus, Imperial College London, Fulham Road, SW10 9NH, London, UK

[6]Knowledge and Intelligence Team (North West), Public Health England, 15-21 Webster Street, L3 2ET, Liverpool, UK

关键词: Child abuse;    Childhood;    Alcohol;    Smoking;    Violence;   

DOI  :  10.1186/1741-7015-12-72

 received in 2014-03-20, accepted in 2014-03-21,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundEpidemiological and biomedical evidence link adverse childhood experiences (ACEs) with health-harming behaviors and the development of non-communicable disease in adults. Investment in interventions to improve early life experiences requires empirical evidence on levels of childhood adversity and the proportion of HHBs potentially avoided should such adversity be addressed.MethodsA nationally representative survey of English residents aged 18 to 69 (n = 3,885) was undertaken during the period April to July 2013. Individuals were categorized according to the number of ACEs experienced. Modeling identified the proportions of HHBs (early sexual initiation, unintended teenage pregnancy, smoking, binge drinking, drug use, violence victimization, violence perpetration, incarceration, poor diet, low levels of physical exercise) independently associated with ACEs at national population levels.ResultsAlmost half (47%) of individuals experienced at least one of the nine ACEs. Prevalence of childhood sexual, physical, and verbal abuse was 6.3%, 14.8%, and 18.2% respectively (population-adjusted). After correcting for sociodemographics, ACE counts predicted all HHBs, e.g. (0 versus 4+ ACEs, adjusted odds ratios (95% confidence intervals)): smoking 3.29 (2.54 to 4.27); violence perpetration 7.71 (4.90 to 12.14); unintended teenage pregnancy 5.86 (3.93 to 8.74). Modeling suggested that 11.9% of binge drinking, 13.6% of poor diet, 22.7% of smoking, 52.0% of violence perpetration, 58.7% of heroin/crack cocaine use, and 37.6% of unintended teenage pregnancy prevalence nationally could be attributed to ACEs.ConclusionsStable and protective childhoods are critical factors in the development of resilience to health-harming behaviors in England. Interventions to reduce ACEs are available and sustainable, with nurturing childhoods supporting the adoption of health-benefiting behaviors and ultimately the provision of positive childhood environments for future generations.

【 授权许可】

CC BY   
© Bellis et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.