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Population attributable fractions of cardiovascular disease and serious mental illness associated with childhood adversity
Methods: Using weighted population-based data from Allegheny County Health Survey (N=5,442), we calculated PAR fractions and 95% confidence intervals for CVD and serious mental illness while controlling for age, race, gender, and lifetime socioeconomic status. We measured SMI using the 6-item Kessler scale and CVD by asking respondents if they were ever told by a health professional that they had a heart attack, angina, coronary heart disease, or a stroke. Childhood Adversity was measured using a modified version of the CDC’s Adverse Childhood Experiences (ACE) scale which asks respondents about child maltreatment experiences and about growing up in a dysfunctional home.
Results: If ACEs were prevented entirely we could expect a decrease of approximately 26.1% (95%CI= 17.4%, 31.8%) in the prevalence of CVD in the population and of 41.3% decrease (95%CI= 35.3%, 44.5%) in the prevalence of SMI.
Conclusion: Exposure to ACEs is strongly associated with CVD and SMI in adulthood. Moreover, CVD and SMI morbidity in the population could be greatly reduced if ACEs were prevented or reduced. Policies and programs to prevent child adversity (e.g., treatment of mental health and substance abuse for families “at risk” for experiencing adversity) may result in significant decreases in CVD and SMI in the general adult population.
Learning Areas:
Chronic disease management and preventionSocial and behavioral sciences
Learning Objectives:
Explain, from a life course perspective, how adverse childhood event can affect mental and cardiovascular health in adulthood.
Describe the Population Attributable Risk of cardiovascular disease and serious mental illness associated with childhood adversity.
Identify programs and policies to prevent adverse childhood experiences.
Keyword(s): Chronic Disease Prevention, Survey
Qualified on the content I am responsible for because: The research presented here comes from my dissertation work, for which I coordinated data collection and conducted all analyses. I direct the Office of Health Survey Research, University of Pittsburgh. In this role I have conducted numerous health and surveillance surveys. My interests are in the prevention of chronic disease from a life course perspective. In this vein I have presented several abstracts and have manuscripts under review and/or in process for publication.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.