Sex-specific relationships between adverse childhood experiences and chronic obstructive pulmonary disease in five states

Timothy J. Cunningham · Earl S. Ford · Janet B. Croft · Melissa T. Merrick · Italia Rolle · Wayne H. Giles

79 citations0/0 files storedInternational Journal of COPD

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Child Abuse and Trauma Chronic Obstructive Pulmonary Disease (COPD) Research Intimate Partner and Family Violence

Abstract

PURPOSE: Adverse childhood experiences (ACEs) before age 18 have been repeatedly associated with several chronic diseases in adulthood such as depression, heart disease, cancer, diabetes, and stroke. We examined sex-specific relationships between individual ACEs and the number of ACEs with chronic obstructive pulmonary disease (COPD) in the general population. MATERIALS AND METHODS: Data from 26,546 women and 19,015 men aged ≥18 years in five states of the 2011 Behavioral Risk Factor Surveillance System were analyzed. We used log-linear regression to estimate prevalence ratios (PRs) and their corresponding 95% confidence intervals (CIs) for the relationship of eight ACEs with COPD after adjustment for age group, race/ethnicity, marital status, educational attainment, employment, asthma history, health insurance coverage, and smoking status. RESULTS: Some 63.8% of women and 62.2% of men reported ≥1 ACE. COPD was reported by 4.9% of women and 4.0% of men. In women, but not in men, there was a higher likelihood of COPD associated with verbal abuse (PR =1.30, 95% CI: 1.05, 1.61), sexual abuse (PR =1.69, 95% CI: 1.36, 2.10), living with a substance abusing household member (PR =1.49, 95% CI: 1.23, 1.81), witnessing domestic violence (PR =1.40, 95% CI: 1.14, 1.72), and parental separation/divorce (PR =1.47, 95% CI: 1.21, 1.80) during childhood compared to those with no individual ACEs. Reporting ≥5 ACEs (PR =2.08, 95% CI: 1.55, 2.80) compared to none was associated with a higher likelihood of COPD among women only. CONCLUSION: ACEs are related to COPD, especially among women. These findings underscore the need for further research that examines sex-specific differences and the possible mechanisms linking ACEs and COPD. This work adds to a growing body of research suggesting that ACEs may contribute to health problems later in life and suggesting a need for program and policy solutions.

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References

1998Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults 2002A life course approach to chronic disease epidemiology: conceptual models, empirical challenges and interdisciplinary perspectives 2009Adverse Childhood Experiences and Adult Risk Factors for Age-Related Disease 2004Insights Into Causal Pathways for Ischemic Heart Disease 2010Building a Framework for Global Surveillance of the Public Health Implications of Adverse Childhood Experiences 2020Adverse Childhood Experiences 2008Adverse Childhood Experiences and Chronic Obstructive Pulmonary Disease in Adults 2010Adverse childhood experiences are associated with the risk of lung cancer: a prospective cohort study

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2017The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis 2019Adverse childhood experiences and associated health outcomes: A systematic review and meta-analysis 2019Life course health consequences and associated annual costs of adverse childhood experiences across Europe and North America: a systematic review and meta-analysis 2015Associations Between Adverse Childhood Experiences, High-Risk Behaviors, and Morbidity in Adulthood

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