期刊
CHILD ABUSE & NEGLECT
卷 111, 期 -, 页码 -出版社
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.chiabu.2020.104804
关键词
Adverse childhood experiences (ACEs); Rural health; Child trauma
资金
- University of California, San Francisco, School of Medicine Inquiry Funding Office
- National Institutes of Health Loan Repayment Program [1 L60 MD013257-01]
- Agency for Healthcare Research and Quality [K12HS026383]
- National Center for Advancing Translational Sciences [KL2TR001870]
This study showed that rural children have a higher burden of adverse childhood experiences compared to suburban children. These findings highlight the importance of ACE screening and suggest investing healthcare resources in historically underserved rural populations.
Background: Previous efforts to examine differences in adverse childhood experiences (ACEs) exposure by geography have yielded mixed results, and have not distinguished between urban, suburban, and rural areas. Additionally, few studies to date have considered the potentially moderating role of geography on the relationship between ACEs and health outcomes. Objective: To examine differences in exposure to ACEs by geography, and determine whether geography moderates the relationship between ACE exposure and health outcomes (overall health, asthma, attention deficit hyperactivity disorder (ADHD), and special health care needs). Participants and setting: The cross-sectional 2017-18 National Survey of Children's Health (NSCH). Methods: Distributions of individual and cumulative ACEs by geography (urban, suburban, rural) were compared using chi-squared tests. Logistic regression was used to determine the association between geography and exposure to 4 + ACEs, and to explore whether the relationship between ACEs and health outcomes varied by geography, adjusting for sociodemographic covariates. Results: Adjusting for covariates, rural residency was associated with 1.29 times increased odds of exposure to 4 + ACEs (95 % CI: 1.00, 1.66) compared to suburban residency. Statistically significant evidence for an interaction between geography and ACE exposure on overall health was not observed, but urban status was observed to increase the association between ACEs and asthma. Conclusions: This analysis demonstrates a higher ACE burden in rural compared to suburban children. These findings underscore the importance of ACE screening and suggest investment of healthcare resources in the historically underserved rural population.
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