An analysis of adverse childhood experiences interrelatedness in Allegheny County

The accumulation of adverse childhood experiences (ACEs) has been found to be highly associated with long-term chronic health outcomes and health risk behaviors in adulthood. The 2009-2010 Allegheny County Health Survey (ACHS) allowed for the detailed analysis of ACE burden in Allegheny County. For the first time, ACE exposures were studied in Allegheny County using exposure definitions established in the original ACE Study. Using a mixture of frequency and multivariate logistic regression analysis, the prevalence ACEs, interrelatedness of exposures, and the cumulative effect of ACEs on health outcomes were studied. ACEs were prevalent in Allegheny County. Nearly 2 in 5 respondents reported at least one trauma category. All exposure categories were highly interrelated with one another, with emotional and physical abuse being the most interrelated. Sexual abuse was also found to accumulate the most additional exposures. The accumulation of ACE exposures greatly increases the odds of developing CHD, suffering current mental distress, and having self-rated fair or poor health. However, differing individual exposures were found to be more important than others in the development of certain health outcomes. Increased understanding of the relationship between ACE exposures and long term chronic health outcomes and health risk behaviors has important public health significance, as it will lead to further refined and targeted interventions and heightened awareness