Adverse Childhood Experiences Among Adult Floridians, 2010 BRFSS

BACKGROUND:   Adverse childhood experiences or “ACEs” are defined as events that negatively alter the developing brain and body. These alterations may have lifelong effects on health. Florida collected population level ACE data through the Behavioral Risk Factor Surveillance System (BRFSS) in 2010. We examined the prevalence of ACEs among Floridians as well as the association between ACEs and health conditions, risk behaviors, and risks for health conditions.

METHODS:   Five ACE items were analyzed in the 2010 Florida BRFSS data. Only individuals who reported abuse by an adult family member were included in the abuse category. An ACE score of zero to five was calculated by summing the number of affirmative responses to each ACE question. Analyses were conducted using SAS 9.3. Comparisons were made using logistic regressions with number of ACEs predicting likelihood of each outcome adjusting for age, race, sex, education level, and household income.

RESULTS:   Approximately 50% of adult Floridians report having experienced at least one ACE during their childhood and around 13% experienced three or more ACEs. Individuals who identified as multi-racial, who had less than a high school diploma, or with a household income less than $25,000 were the most likely to have three or more ACEs. Compared with adults with no ACEs, adults with three ACEs were more likely to report poor health (OR=2.5), report being physically (OR=2.7) and mentally (OR=2.7) unhealthy on 14 or more of the past 30 days, and report being dissatisfied with life (OR=4.5). Additionally, adults with at least one ACE were more likely to be a current or former smoker, engage in binge drinking, and have an HIV risk factor in the past year. Finally, adults with at least three ACEs were more likely to have a number of health conditions, including diabetes (OR=1.7) or pre-diabetes (OR=1.6), arthritis (OR=2.5), asthma (OR=2.0), high cholesterol (OR=1.6), and a heart attack (OR=1.8). All results are statistically significantly different (p<0.05).

CONCLUSIONS:   Adverse childhood experience affects a large proportion of the population and is significantly related to morbidities in Florida. Very few studies have been conducted addressing this issue in Florida. These findings provide important information to public health programs to improve the overall health and well-being of Florida residents with ACE.