Gender-based disparities in the impact of adverse childhood experiences on adult health: findings from a national study in the Kingdom of Saudi Arabia

Abstract

BackgroundAdverse Childhood Experiences (ACEs) have been linked to an increased risk of health and social problems throughout life. Studies on gender differences from developing countries are scarce. In this paper, we will examine gender variations in the types of reported ACEs and gender-specific relationships between cumulative ACEs and physical and mental health, and Risky Health Behaviors (RHB) in adulthood in the Kingdom of Saudi Arabia (KSA).MethodsA cross sectional national study was conducted in all of the 13 regions in KSA in 2013 using the ACE- International Questionnaire (ACE-IQ). We used multivariate logistic regression to examine the relationship between 4 + ACEs and physical, mental health and RHBs for both men and women separately after adjusting for age, education, marital status and current employment.ResultsThe total number of participants was 10,156 and women comprised 48% of the sample. The majority of respondents (80%) reported at least one ACE. Women had higher percentages of < =2 ACEs (65% vs 55%; p <0.05) while men were more likely to have 4+ ACEs (33% vs 25%; p < 0.05). When compared to participants with 0 ACE, men who reported 4+ ACEs were associated with the highest likelihood of using drugs (OR = 9.7; 95% CI: 6.4-14.5) and drinking alcohol (OR = 9.2; 95% CI: 6.3-13.6). On the other hand, women who experienced 4+ ACEs were associated with the highest likelihood of depression (OR = 7.0; 95% CI: 5.2-9.4), anxiety (OR = 6.4; 95% CI: 5.0-8.2) and other mental illnesses (OR = 7.4; 95% CI: 5.2-10.6). As for chronic diseases, abused men and women in childhood showed similarly a twofold increased risk of developing diabetes, hypertension, coronary heart disease and obesity when compared to non-abused participants.ConclusionFindings highlight the need to consider gender specific differences in the development of preventive strategies to address ACEs in KSA.

Socio-Cultural Constraints in Protecting Child Rights in a Society in Transition: A Review and Synthesis from Oman

“…Physically abused children also do poorly at school, as observed by Altamimi et al (2017) who studied 12-19-year-old students in Riyadh, Saudi Arabia. Another study in a nationally representative sample in Saudi Arabia suggests that adverse childhood experiences have the potential to double the risk of developing diabetes, hypertension, coronary heart disease and obesity (Almuneef et al 2017). The limitation of this study was that it could not establish the temporal relationship between the cause and effect as is often the case with cross-sectional studies.…”

Association of Team Sports Participation With Long-term Mental Health Outcomes Among Individuals Exposed to Adverse Childhood Experiences

“…[18][19][20] Team sports in particular are thought to lead to improved mental health because of their social nature and resulting social support. 20,21 However, it is not known whether team sports participation among the subgroup of youths exposed to ACEs is associated with improved mental health outcomes. For example, ACEs may affect children in ways that could alter or limit the benefits of sports participation.…”

Decomposing the effects of childhood adversity on later-life depression among Europeans: a comparative analysis by gender

“…It is anticipated that both mechanisms are relevant. Further, based on past analyses, we expect to observe differentials between men and women; more specifically, it seems possible that SES may have a stronger effect among men (Back and Lee, 2011) where adverse experiences may be more important among women (Flores and Kalwij, 2014; Almuneef et al , 2017).…”