Héctor E Alcalá1, Annalyn Valdez-Dadia2, Ondine S von Ehrenstein3. 1. Department of Family, Population and Preventive Medicine, Stony Brook University, 101 Nicolls Road, Stony Brook, NY, USA. 2. Center for Health Equity Research, California State University, Long Beach, 1250 Bellflower Blvd., MS-4510, FO5-120, Long Beach, CA, USA. 3. Departments of Community Health Sciences and Epidemiology, University of California, Los Angeles, Jonathan and Karin Fielding School of Public Health, 640 Charles E Young Drive S, Los Angeles, CA, USA.
Abstract
Background: Adverse childhood experiences (ACEs) have been associated with a variety of negative health outcomes. However, the association between ACEs and access and utilization of health care have been largely ignored. Methods: This study examined data from the 2011 Behavioral Risk Factor Surveillance System (N = 101 527). We conducted logistic regression analyses, with nine ACEs as independent variables, in relation to the odds of being insured, having a personal health care provider and receiving a physician checkup in the past year. Unadjusted and adjusted multivariable models were estimated. Results: After accounting for potential confounders, all ACEs were associated with lower odds of being currently insured and receiving a physician checkup in the past year. Physical abuse, emotional abuse and several measures of household dysfunction were associated with lower odds of having a personal provider. Conclusions: Our findings suggest potential pathways by which ACEs may impact health. Provision of health insurance and providing care in a trauma-informed manner should be considered for individuals with a history of ACEs.
Background: Adverse childhood experiences (ACEs) have been associated with a variety of negative health outcomes. However, the association between ACEs and access and utilization of health care have been largely ignored. Methods: This study examined data from the 2011 Behavioral Risk Factor Surveillance System (N = 101 527). We conducted logistic regression analyses, with nine ACEs as independent variables, in relation to the odds of being insured, having a personal health care provider and receiving a physician checkup in the past year. Unadjusted and adjusted multivariable models were estimated. Results: After accounting for potential confounders, all ACEs were associated with lower odds of being currently insured and receiving a physician checkup in the past year. Physical abuse, emotional abuse and several measures of household dysfunction were associated with lower odds of having a personal provider. Conclusions: Our findings suggest potential pathways by which ACEs may impact health. Provision of health insurance and providing care in a trauma-informed manner should be considered for individuals with a history of ACEs.
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