Effects on childhood

Research Article

• Title: Adverse childhood experiences and sources of childhood resilience: a retrospective study of their combined relationships with child health and educational attendance.

• Authors: Mark A. Bellis, Karen Hughes, Kat Ford, Katie A. Hardcastle, Catherine A. Sharp, Sara Wood, Lucia Homolova, Alisha Davies.

Abstract

• Background: Adverse childhood experiences (ACEs) such as maltreatment and household stressors can negatively impact health. Community factors may provide resilience and mitigate some harmful effects.

• Objective: Examined the association between ACEs and poor health/school attendance, and the role of community resilience assets.

• Methods:

  • National (Wales) cross-sectional retrospective survey (N=2452), with stratified random probability sampling and a Welsh speakers boost sample (N=471).

  • Data collected via face-to-face interviews at residences.

  • Outcome measures included self-reported poor health, specific conditions (asthma, allergies, headaches, digestive disorders), and school absenteeism.

• Results:

  • Prevalence of poor health and absenteeism rose with ACE count.

  • Community resilience assets were linked to better outcomes. For individuals with ≥4 ACEs, significant resilience assets reduced poor health prevalence from 59.8% to 21.3%.

• Conclusions:

  • Enhanced actions from public services can reduce ACE impacts, improve health, school attendance, and alleviate public service pressures.

  • While complete eradication of ACEs is unlikely, strengthening community assets may offset immediate harms.

Keywords

• Adverse childhood experiences, Resilience, School attendance, Digestive diseases, Asthma.

Background

• Impact of ACEs: ACEs, including abuse and stressors from environments such as domestic violence, can result in lifelong health detriments such as chronic diseases and anti-social behavior.

• Individuals with ≥4 ACEs are:

  • Twice as likely to smoke.

  • Six times more likely to abuse alcohol.

  • Twice as likely to develop serious health conditions like cancer.

Methods

• Sample Size: Core of 2000, aiming for individuals with higher ACE counts.

• Sampling Strategy: Stratified random sampling based on Health Board and deprivation quintiles.

• Data Collection:

  • Letters sent to households with opt-out options.

  • Conducted interviews in March-June 2017, with 2506 completing the study.

• Measurements:

  • ACEs assessed with CDC tools grouped into eleven types.

  • Community resilience assets measured for evidence of support and opportunities.

Results

• Prevalence of ACEs: 48.5% reported at least one ACE (18.9% with 1 ACE, 16.2% with 2-3 ACEs, 13.4% with ≥4 ACEs).

• Common Outcomes: Increased ACE counts corresponded with rising rates of common health conditions and school absenteeism. High ABS and ACE correlation noted, particularly in females and deprived backgrounds.

• Resilience Assets Outcomes: 48.3% of respondents had all resilience assets. Higher access correlated with lower rates of poor childhood health and absenteeism.

Discussion

• ACE Correlations: Strong relationships are established between ACEs and specific childhood health conditions, with variations by condition.

• Importance of Resilience: Not all children exposed to ACEs develop health problems, indicating the role of resilience.

• Community Support: Enhancement of community resilience may significantly mitigate ACE impacts.

Conclusions

• Long-term Findings: ACEs lead to substantial long-term health and developmental costs.

• Need for Action: Integrated public service approaches that account for ACEs can help reduce adverse impacts and promote resilience in youth.

• Investment in Community: Forming and maintaining community support structures are essential for health outcomes and educational success.