Online Program

Adverse childhood experiences: Impact upon intimate partner violence, depression, and suicide attempt among adults in a sample of Southwest tribes

Tuesday, November 5, 2013 : 8:30 a.m. - 8:50 a.m.

Dornell Pete, MPH, Albuquerque Area Southwest Tribal Epidemiology Center, Albuquerque, NM
Kyle Smith, University of New Mexico, Albuquerque, NM
Kevin English, DrPH, Albuquerque Area Indian Health Board, Inc., Albuquerque, NM
Adverse Childhood Experiences (ACE) refer to multiple types of abuse and neglect during childhood. Studies show links between ACE and behavioral health manifestations in adulthood such as Intimate Partner Violence (IPV), depression, and suicide in the United States. This association has not been explored in American Indian populations despite the fact American Indians experience the highest burden of mental illness, IPV, and suicide. Face-to-face Behavioral Risk Factor Surveillance System (BRFSS) interviews were conducted with 663 adults in a sample of southwest tribes from 2008-2010. The instrument included an 8-item ACE module and measures of suicide, IPV, and depression. To measure the cumulative effects of ACE, a four level scale (1, 2, 3, 4+) was used assigning one point for each ACE occurrence. The burden of ACE ranged from 7% to 51% for each ACE type. 32% reported no ACE, and 22%, 16%, 9%, and 21% reported ACE scores of 1, 2, 3, 4+ respectively. 20% of adults experienced IPV, 15% reported depression, and 9% attempted suicide. Results showed statistically significant relationships (p<0.05) between ACE and adult behavioral health outcomes. Adults with high ACE scores (4+) were 3.5-7.2 times more likely to experience depression, suicide, or IPV than adults with low ACE scores. These findings demonstrate that ACE is a serious public health concern for American Indians. The need for culturally appropriate interventions to prevent ACE exposure and strengthen resiliency among American Indian youth is critical, and may beneficially mitigate behavioral health concerns in adulthood such as suicide, IPV, and depression.

Learning Areas:

Advocacy for health and health education
Assessment of individual and community needs for health education
Diversity and culture
Public health or related education
Social and behavioral sciences

Learning Objectives:
Discuss significant associations between ACE and health outcomes. Formulate awareness of ACE and health outcomes among Southwest American Indians. Demonstrate need for behavioral health services/intervention around ACE among Southwest American Indian youth and adults.

Keyword(s): American Indians, Child/Adolescent Mental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the Epidemiologist of Southwest Tribal Behavioral Risk Surveillance Survey (BRFSS) projects that determine the health and risk behaviors of tribal communities. My experience in epidemiology and statistics has been to determine the health status of American Indians. One of my interests in the anaysis of BRFSS data is to determine the association/relationship of Adverse Childhood Experiences and negative health outcomes among American Indian in the Southwest.
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.