Online Program

317072
Are the Associations between Adverse Childhood Experiences and Chronic Diseases Stronger in Women than in Men?


Tuesday, November 3, 2015 : 4:40 p.m. - 4:50 p.m.

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
Anne G. Wheaton, 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
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
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: Studies have linked adverse childhood experiences (ACE) to harmful health behaviors and the development of chronic diseases in adulthood. However, gender differences have not been comprehensively evaluated in a population-based sample.

Methods: Using data from 15,844 women and 10,134 men aged ≥18 years in 4 states of the 2012 Behavioral Risk Factor Surveillance System, we estimated adjusted prevalence ratios (PR) and 95% confidence intervals (CI) for associations between ACE and arthritis, asthma, cancer, chronic obstructive pulmonary disease (COPD), coronary heart disease (CHD), depression, diabetes, kidney disease, and stroke, adjusting for sociodemographic characteristics.

Results: Some 61.0% of women and 59.8% of men reported ≥ 1 ACE. Women who had experienced ≥ 5 ACE, compared to those who had experienced none, reported more arthritis (PR=1.54, 95% CI: 1.38, 1.72), asthma (PR=1.70, 95% CI: 1.39, 2.09), cancer (PR=1.68, 95% CI: 1.31, 2.16), COPD (PR=2.26, 95% CI: 1.82, 2.82), CHD (PR=1.56, 95% CI: 1.17, 2.07), depression (PR=3.24, 95% CI: 2.85, 3.70), kidney disease (PR=2.09, 95% CI: 1.39, 3.17), and stroke (PR=2.11, 95% CI: 1.42, 3.13). Men who had experienced ≥ 5 ACE, compared to those who had experienced none, reported more arthritis (PR=1.45, 95% CI: 1.22, 1.73), asthma (PR=1.67, 95% CI: 1.19, 2.33), COPD (PR=2.11, 95% CI: 1.45, 3.06), CHD (PR=1.59, 95% CI: 1.16, 2.19), and depression (PR=3.12, 95% CI: 2.54, 3.84).

Conclusions: ACEs were associated with more chronic diseases in women than in men. Policy and intervention solutions that decrease exposure to maltreatment and household or family challenges during childhood are warranted.

Learning Areas:

Epidemiology
Social and behavioral sciences

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

Keyword(s): Violence & Injury Prevention, Chronic Disease Prevention

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 5 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.