Adverse childhood experiences,mental health,and excessive alcohol use: Examination of race/ethnicity and sex differences |
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| Institution: | 1. Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, NE MS F-64, Atlanta, 30341, GA, United States;2. Division of Analysis, Research, and Practice Integration, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, United States;1. Children''s Hospital of Philadelphia, Philadelphia, PA, USA;2. Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA;3. Department of Family Medicine and Community Health, Hospital of the University of Pennsylvania, Philadelphia, PA, USA;4. Mixed Methods Research Lab, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA;5. Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, USA;6. Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA;7. Violence Prevention Initiative, Center for Injury Research and Prevention, Children''s Hospital of Philadelphia, Philadelphia, PA, USA;8. Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA;9. Robert Wood Johnson Foundation, Princeton, NJ, USA;10. Public Health Management Corporation, Philadelphia, PA, USA;11. St. Christopher''s Hospital for Children, Philadelphia, PA, USA;12. Department of Pediatrics, Drexel University School of Medicine, Philadelphia, PA, USA;13. Boston University School of Medicine, Boston, MA, USA;1. Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AK;2. Arkansas State Hospital, Little Rock, AK |
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| Abstract: | Responses from N = 60,598 interviews from the 2010 Behavioral Risk Factor Surveillance System (the 10 states and the District of Columbia that included the optional Adverse Childhood Experience (ACE) module) were used to test whether associations between childhood adversity and adult mental health and alcohol behaviors vary by race/ethnicity and sex. ACE items were categorized into two types – household challenges and child abuse. Outcomes were current depression, diagnosed depression, heavy drinking and binge drinking. Logistic regression models found ACEs significantly associated with depression and excessive alcohol use, but sex did not moderate any relationships. Race/ethnicity moderated the relationship between ACEs and heavy drinking. In stratified analyses, compared to those not exposed to ACEs, non-Hispanic blacks who experienced either type of ACE were about 3 times as likely to drink heavily; Non-Hispanic whites who experienced child abuse or both ACE types were 1.5–2 times as likely to drink heavily; and Hispanics who experienced household challenges or both ACE types were 1.2 and 11 times as likely to report heavy drinking. ACEs impact depression and excessive alcohol use similarly across men and women. With the exception of heavy drinking, ACEs appear to have the same association with excessive alcohol use across race/ethnicity. It may be prudent to further investigate why the relationship between ACEs and heavy drinking may differ by race/ethnicity such that prevention strategies can be developed or refined to effectively address the needs of all sub-groups. |
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| Keywords: | Adverse childhood experiences Race/ethnicity Heavy drinking Household challenges Child abuse BRFSS |
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