142nd APHA Annual Meeting and Exposition

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305933
Gender-specific relationships between adverse childhood experiences and chronic obstructive pulmonary disease in five states

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014 : 3:00 PM - 3:15 PM

Timothy J. Cunningham, ScD; LCDR, USPHS , National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA
Earl S. Ford, MD, MPH , National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA
Janet B. Croft, PhD , National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA
Melissa Merrick, PhD , National Center for Injury Prevention and Control, Division of Violence Prevention, Centers for Disease Control & Prevention, Atlanta, GA
Italia Rolle, PhD , National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA
Wayne H. Giles, MD, MS , National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA
Background: Adverse childhood experiences (ACE) have been repeatedly associated with chronic diseases in adulthood. We examined gender-specific relationships between individual ACEs and the number (sum) of ACEs with chronic obstructive pulmonary disease (COPD) in the general population.

Methods: Data from 26,546 women and 19,015 men aged ≥ 18 years in the 2011 Behavioral Risk Factor Surveillance System were analyzed and eight ACEs were examined. We used log-linear regression to estimate prevalence ratios (PRs) and their corresponding 95% confidence intervals (CIs) after adjustment for age, race/ethnicity, marital status, educational attainment, employment, asthma history, health insurance coverage, and smoking status.

Results: Some 63.8% of women and 62.3% of men reported ≥ 1 adverse childhood experience. COPD was reported by 4.9% of women and 4.0% of men. For women, verbal abuse (adjusted PR=1.30, 95% CI: 1.05, 1.61), sexual abuse (adjusted PR=1.69, 95% CI: 1.36, 2.11), living with a substance abusing household member (adjusted PR=1.49, 95% CI: 1.23, 1.81), witnessing domestic violence (adjusted PR=1.40, 95% CI: 1.14, 1.72), and parental separation/divorce (adjusted PR=1.47, 95% CI: 1.20, 1.79)  were all associated with a higher likelihood of COPD compared to those with no individual ACEs. For men, living with an incarcerated household member (adjusted PR=0.49, 95% CI: 0.31, 0.77) was associated with a lower likelihood of COPD. Reporting ≥ 5 ACEs (adjusted PR=2.08, 95% CI: 1.55, 2.80) was associated with a higher likelihood of COPD compared to reporting no ACEs among women only.

Conclusions: These findings suggest that ACEs are related to COPD, especially among women. Intervention strategies need to consider how this relationship varies by gender.

Learning Areas:

Chronic disease management and prevention
Epidemiology
Social and behavioral sciences

Learning Objectives:
Define the public health problems of adverse childhood experiences and chronic obstructive pulmonary disease. Identify how gender influences the association between adverse childhood experiences and chronic obstructive pulmonary disease. Discuss the importance of programs and policies that promote safe, stable, and nurturing childhood social environments.

Keyword(s): Violence & Injury Prevention, Epidemiology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been an epidemiologist at the Centers for Disease Control and Prevention for 4 years. My research has been oriented towards understanding differences in health related to socioeconomic status, different racial/ethnic groups, and gender.
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.

Back to: 3354.0: Asthma and Respiratory Disease Epidemiology