Abstract 169: Assessment Of Adverse Childhood Experiences In The South Bronx On Risk Of Developing Chronic Diseases As Adults
Background: Adverse Childhood Experiences (ACE) are understood to have a negative impact on health outcomes. Events such as abuse, neglect, family dysfunction early in life have shown a strong association with cardiovascular disease (CVD), as well as, premature death in adulthood. Our objective was to identify the prevalence of ACE events within the South Bronx, NY population and the relationship these stressors have with chronic disease affecting CVD health and high-risk behaviors in adults.
Methods: Patients were recruited from a hospital-based ambulatory primary care. The survey was conducted between September 2017 and January 2018 with questions on demographics, ACE events, high-risk behavior (smoking, alcohol dependence, substance abuse), mental health, and chronic disease (hypertension, diabetes, hyperlipidemia) with patients of the S. Bronx. The chronic disease was stratified to assess for association with ACE score (1 to 11) and ACE event subcategories.
Results: A total of 454 patients participated in the study. The overall age was 53.1±14.2 years and females were 49%. Hispanic were 54% followed by Black at 20%. Subjects had a high prevalence of both chronic disease (82%) and ACE events (69%) within the community. Our findings demonstrated a significant relationship between ACE events with chronic disease and high-risk behavior with higher odds among subjects with exposure to childhood stressors (OR 1.26, 95% CI- 1.1-1.5, p<0.01). Each ACE category – Physical & Sexual abuse, Household substance abuse, Separation from parents, Incarcerated household member, Parental separation/divorce, and Bullying – was associated with one and more chronic CVD diseases (OR-2.03, 21.53, 2.82, 2.94, 2.61, 3.83, & 4.84, respectively) significantly, p<0.01. High-risk behaviors were significant and correlated with an ACE score of more than 4.
Conclusion: Among residents of the S. Bronx, having one or more ACE events had a significant association with chronic disease. Socio-economically deprived regions, such as S. Bronx, should entail ACE surveillance to detect exposure to risk factors that stimulate a need for evidence-based interventions that can be assigned to social determinants of health and aid with mental health and early screening for CVD risk factors.