Adverse childhood experiences and access and utilization of health care

Abstract

Background: Adverse childhood experiences (ACEs) have been associated with a variety of negative health outcomes. However, the association between ACEs and access and utilization of health care have been largely ignored. Methods: This study examined data from the 2011 Behavioral Risk Factor Surveillance System (N = 101 527). We conducted logistic regression analyses, with nine ACEs as independent variables, in relation to the odds of being insured, having a personal health care provider and receiving a physician checkup in the past year. Unadjusted and adjusted multivariable models were estimated. Results: After accounting for potential confounders, all ACEs were associated with lower odds of being currently insured and receiving a physician checkup in the past year. Physical abuse, emotional abuse and several measures of household dysfunction were associated with lower odds of having a personal provider. Conclusions: Our findings suggest potential pathways by which ACEs may impact health. Provision of health insurance and providing care in a trauma-informed manner should be considered for individuals with a history of ACEs.

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