The Effects of Adverse Childhood Experiences on Self-Reported Physical and Mental Health Outcomes in Adulthood
Abstract
The number of physically and mentally unhealthy days as a measure of health-related quality of life (HRQOL) is used to examine the different effects of the adverse childhood experiences (ACEs) on physical and mental health outcomes. The data, a cross-sectional state-level survey, is obtained from the Behavioral Risk Factor Surveillance System (BRFSS) collected by the Centers for Disease Control and Prevention (CDC) in 2012. Multiple regression analyses are conducted for the study. The results indicate that all individual ACE categories are inversely associated with both physical and mental health, as respondents who exposed to any adverse childhood experience are likely to have physically- and mentally-related poor HRQOL in adulthood. The estimated coefficients for individual ACEs in magnitude on the mental health outcome are, in overall, greater than the estimated coefficients on the physical health outcome. The regression results with accumulative ACE scores indicate that higher levels of the ACE score would affect higher negative health outcomes, such as the dosage effects that appear again in this study. The estimated coefficients of accumulative ACE scores on the mental health outcome exceed the coefficients of ACE scores on physical health outcome for an ACE score of 2 and above. The gap in the estimated coefficients of ACE scores between physically and mentally unhealthy days increases as the ACE score rises. The estimated coefficient at the score ACE8 for the mentally unhealthy days becomes almost twice as large as the coefficient for the physically unhealthy days. Importantly, the negative effects of ACEs on mental health outcomes are significantly greater than the negative effects on physical health outcomes.Downloads
References
Acree, L. S., Longfors, J., Fjeldstad, A. S., Fjeldstad, C., Schank, B., Nickel, K. J., Montgomery, P. S. & Gardner, A. W. (2006). Physical Activity Is Related to Quality of Life in Older Adults. Health and Quality of Life Outcomes, 4(37). Published online 2006 Jun 30. doi: 10.1186/1477-7525-4-37. DOI: https://doi.org/10.1186/1477-7525-4-37
Adam, E. K., Chyu, L., Hoyt, L. T., Doane, L. D., Boisjoly, J., Duncan, G. J., Chase-Lansdale, L. & McDade, T. W. (2011). Adverse Adolescent Relationship Histories and Young Adult Health: Cumulative Effects of Loneliness, Low Parental Support, Relationship Instability, Intimate Partner Violence, and Loss. Journal of Adolescent Health, 49, 278-286. DOI: https://doi.org/10.1016/j.jadohealth.2010.12.012
Ahluwalia, I. B., Holtzman, D., Mack, K. A. & Mokdad, A. (2003). Health-Related Quality of Life among Women of Reproductive Age: Behavioral Risk Factor Surveillance System (BRFSS), 1998-2001. Journal of Women’s Health, 12, 5-9. DOI: https://doi.org/10.1089/154099903321154086
Anda, R. F., Felitti, V. J., Douglas B. J., Walker, J. D., Whitfield, C., Perry B. D., Dube, S. R. & Giles, W. H. (2006). The Enduring Effects of Abuse and Related Adverse Experiences in Childhood. Eur Arch Psychiatry Clin Neurosci, 256, 174-186. DOI: https://doi.org/10.1007/s00406-005-0624-4
Andreson, E. M., Catlin, T. K., Wyrwich, K. W. & Jackson-Thompson, J. (2003). Retest Reliability of Surveillance Questions on Health Related Quality of Life. Journal of Epidemiology and Community Health, 57, 339-343. DOI: https://doi.org/10.1136/jech.57.5.339
Braveman, P. & Gottlieb, L. (2014). The Social Determinants of Health: It’s Time to Consider the Causes of the Causes. Public Health Reports, 129, 19-31. DOI: https://doi.org/10.1177/00333549141291S206
Brown, M. J., Thacker, L. R. & Cohen, S. A. (2013). Association between Adverse Childhood Experiences and Diagnosis of Cancer. PLoS ONE, 8(6): e65524. doi:10.1371/journal.pone.0065524. DOI: https://doi.org/10.1371/journal.pone.0065524
Brown, W. J., Trost, S. G., Bauman, A., Munnery, k. & Owen, N. (2004). Test-Retest Reliability of Four Physical Activity Measures used in Population Surveys. Journal of Science and Medicine in Sport, 7, 205-215. DOI: https://doi.org/10.1016/S1440-2440(04)80010-0
Cerne, A., Svab, I., Kersnik, J. & Selic, P. (2013). Did Past Economic Prosperity Affect the Health Related Quality of Life Predictors? A Longitudinal Study on a Representative Sample of Slovenian Family Medicine Patients. BMC Public Health, 13(1160), doi: 10.1186/1471-2458-13-1160. DOI: https://doi.org/10.1186/1471-2458-13-1160
Chapman, D. P., Liu, Y., Presley-Cantrell, L. R., Edwards, V. J., Wheaton, A. G., Perry, G. S. & Croft J. B. (2013). Adverse Childhood Experiences and Frequent Insufficient Sleep in 5 U.S. States, 2009: a Retrospective Cohort Study. BMC Public Health, 13 (3), 1-9.
Chartier, M. J., Walker, J. R. & Naimark, B. (2010). Separate and Cumulative Effects of Adverse Childhood Experiences in Predicting Adult Health and Health Care Utilization. Child Abuse & Neglect, 34, 454-464. DOI: https://doi.org/10.1016/j.chiabu.2009.09.020
Chen, H. Y., Baumgardner, D. J., Rice, J. P. (2011). Health-Related Quality of Life Among Adults With Multiple Chronic Conditions in the United States, Behavioral Risk Factor Surveillance System, 2007. Preventing Chronic Disease, 8, 1-9.
Chou, S., Grossman, M. & Saffer, H. (2004). An Economic Analysis of Adult Obesity: Results from the Behavioral Risk Factor Surveillance System. Journal of Health Economics, 23, 565-587. DOI: https://doi.org/10.1016/j.jhealeco.2003.10.003
Clifford, E. L., Collins, M. M., Buckley, C. M., Fitzgerald, A. P. & Perry, I. J. (2013). Unhealthy Days and Quality of Life in Irish Patients with Diabetes. PLoS ONE, 8 (12): e81102. Doi:10.1371/journal.pone.0081102. DOI: https://doi.org/10.1371/journal.pone.0081102
Cohen, J., Cohen, P., West, S. G. & Aiken, L. S. (2003). Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences. Lawrence Erlnaum Associated, Inc., Mahawah, NJ.
DuMouchel, W. & Duncan, G. J. (1983). Using Sample Survey Weights in Multiple Regression Analysis of Stratified Samples. Journal of the American Statistical Association, 78, 535–543. DOI: https://doi.org/10.1080/01621459.1983.10478006
Evenson, K. R. & McGinn, A. P. (2005). Test-Retest Reliability of Adults Surveillance Measures for Physical Activity and Inactivity. American Journal of Preventive Medicine, 28, 470-478. DOI: https://doi.org/10.1016/j.amepre.2005.02.005
Ford, E. S., Anda, R. F., Edwards, V. J., Perry, G. S., Zhao, G., Li, C. & Croft, J. B. (2011). Adverse Childhood Experiences and Smoking Status in Five States. Preventive Medicine, 53, 188-193. DOI: https://doi.org/10.1016/j.ypmed.2011.06.015
Ford, E. S., Mannino, D. M., Homa, D. M., Gwynn, C., Redd, S. C., Moriarty, D. G. & Mokdad A. H. (2003). Self-Reported Asthma and Health-Related Quality of Life. Chest, 123, 119-127. DOI: https://doi.org/10.1378/chest.123.1.119
Ford, E. S., Mokdad, A. H., Li, C., McGuire, L. C., Strine, T. W., Okiro, C. A., Brown, D. W. & Zack, M. M. (2008). Gender Differences in Coronary Heart Disease and Health-Related Quality of Life: Findings from 10 States from the 2004 Behavioral Risk Factor Surveillance System. Journal of Women’s Health, 17, 757-768. DOI: https://doi.org/10.1089/jwh.2007.0468
Heath, G. W. & Brown, D. W. (2009). Recommended Levels of Physical Activity and Health Related Quality of Life among Overweight and Obese Adults in the United States. 2005. Journal of Physical Activity and Health, 6, 403-411. DOI: https://doi.org/10.1123/jpah.6.4.403
Heslin, K. C., Stein, J. A., Heinzerling, K. G., Pan, D., Magladry, C. & Hays, R. D. (2011). Clinical Correlates of Health-related Quality of Life among Opioid-dependent Patients. Qual Life Res, 20(8), 1205-1213. DOI: https://doi.org/10.1007/s11136-011-9858-y
Huang, C. Y., Hsu, M. C. & Chen, T. J. (2012). An Exploratory Study of Religious Involvement as a Moderator between Anxiety, Depressive Symptoms and Quality of Life Outcomes of Older Adults. Journal of Clinical Nursing, 21, 609-618. DOI: https://doi.org/10.1111/j.1365-2702.2010.03412.x
Jia, H. & Lubetkin, E. I. (2009). Time Trends and Seasonal Patterns of Health-Related Quality of Life Among U.S. Adults. Public Health Report, 124, 692-701. DOI: https://doi.org/10.1177/003335490912400511
Jiang, Y. & Hesser, J. E. (2008). Patterns of Health-related Quality of Life and Patterns Associated with Health Risks among Rhode Island Adults. Health and Quality of Life Outcomes, 6(49), doi: 10.1186/1477-7525-6-49. DOI: https://doi.org/10.1186/1477-7525-6-49
Liu, Y., Croft, J. B., Chapman, D. P., Perry, G. S., Greenlund, K. J., Zhao, G. & Edwards, V. J. (2013). Relationship between Adverse Childhood Experiences and Unemployment among Adults from five US States. Soc Psychiatry Psychiatr Epidemiol, 48, 357-369. DOI: https://doi.org/10.1007/s00127-012-0554-1
Maddala, G. S. (1992). Introduction to Economics, Second Edition, Macmillan Publishing Company, New York.
Mahabaleshwarkar, R., Khanna, R., West Strum, D. & Yang, Y. (2013). Association between Health-Related Quality of Life and Colorectal Cancer Screening. Population Health Management, 16, 178-189. DOI: https://doi.org/10.1089/pop.2012.0044
Mersky, J. P., Topitzes, J. & Reynolds, A. J. (2013). Impacts of Adverse Childhood Experiences on Health, Mentalhealth, and Substance Use in Early Adulthood: A Cohort Study of an Urban, Minority Sample in the U.S. Child Abuse & Neglect, 37, 917-925. DOI: https://doi.org/10.1016/j.chiabu.2013.07.011
Mesbah, M. (2004). Measurement and Analysis of Health Related Quality of Life and Environment Data. Environmetrics, 15, 471-481. DOI: https://doi.org/10.1002/env.680
Meyer, O. L., Castro-Schilo, L. & Aguilar-Gaxiola, S. (2014). Determinants of Mental Health and Self-Rated Health: A Model of Socioeconomic Status, Neighborhood Safety, and Physical Activity. American Journal of Public Health, 104(9), 1734-1741. DOI: https://doi.org/10.2105/AJPH.2014.302003
Miles, A. & Proescholdbell, R. J. (2011). Explaining Rural/non-rural Disparities in Physical Health-related Quality of Life: a Study of United Methodist Clergy. Quality of Life Research, 20, 807-815. DOI: https://doi.org/10.1007/s11136-010-9817-z
Montgomery, A. E., Cutuli, J. J., Evans-Chase, M., Treglia, D. & Culhane, D. P. (2013). Relationship Among Adverse Childhood Experiences, History of Active Military Service, and Adult Outcomes: Homelessness, Mental Health, and Physical Health. American Journal of Public Health, 103, S262-S268. DOI: https://doi.org/10.2105/AJPH.2013.301474
Mostoufi, S. M., Strachan, E., Chopko, L., Succop, A., Martinez, B., Ahumada, S. M. & Afari, N. (2013). Adverse childhood experiences, health perception, and the role of shared familial factors in adult twins. Child Abuse & Neglect, 37, 910–916. DOI: https://doi.org/10.1016/j.chiabu.2013.06.005
Schüsseler-Fiorenza Rose, S. M., Xie, D. & Stineman, M. (2014). Adverse Childhood Experiences and Disability in U.S. Adults. American Academy of Physical Medicine and Rehabilitation, 6, 670-680.
Simms, K., Hacker, D. S., Parker, A. J., Figuereo, M. E. & Bock, S. (2013). Do Past or Present Adverse Relationship experiences Have Greater Impact on Mental and Physical Health? Advances in Mental Health, 11(2), 122-130.
Son, C. H. & Lee, D. H. (2014). The Effects of Alcohol Consumption Patterns on Cardiovascular Disease: An Empirical Study with Behavioral Risk Factor Surveillance System Data. The Empirical Economics Letters, 13(7), 723-730.
Studenmund, A. H. (1992). Using Econometrics (second edition). Harper Collins Publishers Inc., New York.
Theofilou, P. (2013). Quality of Life: Definition and Measurement. Europe’s Journal of Psychology, 9(1), 150-162. DOI: https://doi.org/10.5964/ejop.v9i1.337
Wang, Y. (2008). Physical Activities and Health-Related Quality of Life in Older Adults: Finding from the BRFSS 200. Annual in Therapeutic Recreation, XVI, 102-113.
Zullig, K. J. & Hendryx, M. (2010). A Comparative Analysis of Health-Related Quality of Life for Residents of U.S. Counties with a without Coal Mining. Public Health Report, 125, 548-555. DOI: https://doi.org/10.1177/003335491012500410
Copyright (c) 2016 Journal of Economics and Behavioral Studies
This work is licensed under a Creative Commons Attribution 4.0 International License.
Author (s) should affirm that the material has not been published previously. It has not been submitted and it is not under consideration by any other journal. At the same time author (s) need to execute a publication permission agreement to assume the responsibility of the submitted content and any omissions and errors therein. After submission of a revised paper in the light of suggestions of the reviewers, editorial team edits and formats manuscripts to bring uniformity and standardization in published material.
This work will be licensed under Creative Commons Attribution 4.0 International (CC BY 4.0) and under condition of the license, users are free to read, copy, remix, transform, redistribute, download, print, search or link to the full texts of articles and even build upon their work as long as they credit the author for the original work. Moreover, as per journal policy author (s) hold and retain copyrights without any restrictions.
