Life course health consequences and associated annual costs of adverse childhood experiences across Europe and North America: a systematic review and meta-analysis

Bellis, Mark A; Hughes, Karen; Ford, Kat; Rodriguez, Gabriela; Sethi, Dinesh; Passmore, Jonathon

doi:10.1016/s2468-2667(19)30145-8

Cited by 674 publications

(651 citation statements)

References 46 publications

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“…Persons reporting more types of adverse childhood experiences were at highest risk. These findings are consistent with those from similar analyses conducted in England, Europe, and North America ( 1 , 2 ) and suggest that preventing adverse childhood experiences might reduce occurrences of the outcomes examined, with potential reductions ranging from 1.7% (overweight or obesity) to 44.1% (depression). Given these findings, preventing adverse childhood experiences could have broad positive health, social, and economic impacts.…”

Section: Discussionsupporting

confidence: 88%

Vital Signs: Estimated Proportion of Adult Health Problems Attributable to Adverse Childhood Experiences and Implications for Prevention — 25 States, 2015–2017

Merrick¹,

Ford²,

Ports³

et al. 2019

MMWR Morb. Mortal. Wkly. Rep.

488

375

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IntroductionAdverse childhood experiences, such as violence victimization, substance misuse in the household, or witnessing intimate partner violence, have been linked to leading causes of adult morbidity and mortality. Therefore, reducing adverse childhood experiences is critical to avoiding multiple negative health and socioeconomic outcomes in adulthood.MethodsBehavioral Risk Factor Surveillance System data were collected from 25 states that included state-added adverse childhood experience items during 2015–2017. Outcomes were self-reported status for coronary heart disease, stroke, asthma, chronic obstructive pulmonary disease, cancer (excluding skin cancer), kidney disease, diabetes, depression, overweight or obesity, current smoking, heavy drinking, less than high school completion, unemployment, and lack of health insurance. Logistic regression modeling adjusting for age group, race/ethnicity, and sex was used to calculate population attributable fractions representing the potential reduction in outcomes associated with preventing adverse childhood experiences.ResultsNearly one in six adults in the study population (15.6%) reported four or more types of adverse childhood experiences. Adverse childhood experiences were significantly associated with poorer health outcomes, health risk behaviors, and socioeconomic challenges. Potential percentage reductions in the number of observed cases as indicated by population attributable fractions ranged from 1.7% for overweight or obesity to 23.9% for heavy drinking, 27.0% for chronic obstructive pulmonary disease, and 44.1% for depression.Conclusions and implications for public health practiceEfforts that prevent adverse childhood experiences could also potentially prevent adult chronic conditions, depression, health risk behaviors, and negative socioeconomic outcomes. States can use comprehensive public health approaches derived from the best available evidence to prevent childhood adversity before it begins. By creating the conditions for healthy communities and focusing on primary prevention, it is possible to reduce risk for adverse childhood experiences while also mitigating consequences for those already affected by these experiences.

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Section: Discussionsupporting

confidence: 88%

Vital Signs: Estimated Proportion of Adult Health Problems Attributable to Adverse Childhood Experiences and Implications for Prevention — 25 States, 2015–2017

Merrick¹,

Ford²,

Ports³

et al. 2019

MMWR Morb. Mortal. Wkly. Rep.

488

375

View full text Add to dashboard Cite

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“…Prior reviews have revealed the long-term effects of ACEs on developmental disruptions, negative adult psychological and physical health outcomes, risky health behaviors, increased healthcare utilization [ 5 , 8 – 12 ], and associated high societal financial burden [ 13 , 14 ]. The total annual costs attributable to ACEs for six causes of ill health (cancer, diabetes, cardiovascular disease, respiratory disease, anxiety, depression) is estimated to range between US$417 and $487 billion in Europe and North America, with over 75% of the cost arising in individuals with two or more ACEs [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Adverse childhood experience and adult persistent pain and disability: protocol for a systematic review and meta-analysis

et al. 2020

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Background A growing body of research highlights the pervasive harms of adverse childhood experiences (ACEs) on health throughout the life-course. However, findings from prior reviews and recent longitudinal studies investigating the association between types of ACEs and persistent pain have yielded inconsistent findings in the strength and direction of associations. The purpose of this review is to appraise and summarize evidence on the relationship between ACEs and persistent pain and disability outcomes in adulthood. The specific aims are (1) to determine whether there is a relationship between exposure to ACE and persistent pain and disability in adults and (2) to determine whether unique and cumulative ACEs exposures (number and type) increase the risk of developing persistent pain and disability in adulthood. Method A systematic review and meta-analysis of observational studies will be conducted. Our eligibility criteria are defined following a PECOS approach: population, adults with persistent (≥ 3 months) musculoskeletal and somatoform painful disorders exposed to single or cumulative direct ACEs alone (i.e., physical, sexual, emotional abuse or neglect) or in combination to indirect types of ACE (e.g., parental death, exposure to domestic violence) in the first 18 years of life; comparators, unexposed individuals; outcomes, measurements for persistent pain (≥ 3 months) and disability using discrete and/or continuous measures; and settings, general population, primary care. A comprehensive search of MEDLINE (Ovid) and nine other pertinent databases was conducted from inception to 29 August 2019 using a combination of key words and MeSh terms (the search will be updated prior to conducting the analyses). Pairs of reviewers will independently screen records and full text articles, and a third reviewer will be consulted in cases of disagreement. Data will be extracted using Endnote and Covidence and a meta-analysis will be conducted using Review Manager (RevMan) Version 5.3. The Scottish Intercollegiate Guidelines Network (SIGN) and the Joanna Briggs Institute (JBI) checklists will be used to assess the quality of the included studies. If heterogeneity is high, the findings will be presented in narrative form. Discussion The present review will help consolidate knowledge on persistent pain and disability by evaluating whether frequency and type of adverse childhood experiences produces the most harm. Findings may help inform practitioners and policy-makers who endeavor to prevent and/or mitigate the consequences of ACEs and promote healthy development and well-being of children, youth, and families. Systematic review registration PROSPERO CRD42020150230

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“…Awareness on consent, from early ages, has to do with freedom, shaping the limits of one's own body and that of the other person. Duress, coercion and any similar kinds of acts committed by another individual, are considered harmful and they can potentially involve seriously adverse life-course health consequences (Bellis et al, 2019). Indeed, sexual harassment and gender-based violence have serious negative repercussions on people's physical and mental health (World Health Organization [WHO], 2018).…”

Section: Introductionmentioning

confidence: 99%

Contributions From Psychology to Effectively Use, and Achieving Sexual Consent

2020

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Psychology related to areas such as gender, language, education and violence has provided scientific knowledge that contributes to reducing coercive social relationships, and to expanding freedom in sexual-affective relationships. Nonetheless, today there are new challenges that require additional developments. In the area of consent, professionals from different fields, such as law, gender, and education, are in need of evidence differentiating human communication that produces consent, and those conditions that coerce. Up to now, consent has been focused on verbal language, for example, "no means no," or "anything less than yes is no." Despite the fact that focusing consent on verbal language is a very important part of the problem, it does not solve most of the issues currently raised, like the famous case of "La Manada" in Spain. This article presents the most recent results of a new line of research, which places the problem and the solution in communicative acts, not only in speech acts. Even though there might be a "yes" in a sexual-affective relationship, there might not be consent, and it is indeed a coercive relationship if that "yes" has been given in a relationship determined by institutional power or by interactive power. Institutional power may occur if whoever made the proposal for the relationship is a person in charge of the process of selecting personnel in a company, and one of the candidates is the person who receives the proposal. Interactive power may occur if whoever makes the proposal is situated in an equal or inferior position in the company to the person receiving it, but the former threatens sextortion the latter. The potential social impact of this research has been already shown in the cases analyzed for this study.

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Life course health consequences and associated annual costs of adverse childhood experiences across Europe and North America: a systematic review and meta-analysis

Cited by 674 publications

References 46 publications

Vital Signs: Estimated Proportion of Adult Health Problems Attributable to Adverse Childhood Experiences and Implications for Prevention — 25 States, 2015–2017

Vital Signs: Estimated Proportion of Adult Health Problems Attributable to Adverse Childhood Experiences and Implications for Prevention — 25 States, 2015–2017

Adverse childhood experience and adult persistent pain and disability: protocol for a systematic review and meta-analysis

Contributions From Psychology to Effectively Use, and Achieving Sexual Consent

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