Adverse childhood experiences and association with poorer health and health-harming behaviours in adulthood among the Americans

Background: Adverse childhood experiences (ACEs) such as abuse and neglect have an immediate impact on children and are associated with poorer health and behavioural outcomes in adulthood. This study examined the prevalence of ACEs and their association with socio-demographic factors, physical and mental health, morbidity and health-harming behaviours in adulthood among Americans. Method: Data for the study come from the 2019 Behavioral Risk Factor Surveillance System (BRFSS), covering a sample of 116 032 adult respondents from 22 states of the United States. Descriptive and inferential statistical techniques, including multiple logistic regression models, were employed to analyse the data. Results: At least one kind of ACE was found to be quite common among American adults, as 60% of adults had at least one kind of ACE, 22.5% had one ACE and 17% had four or more ACEs during 0–17 years of life. Of the total ACEs, 42.2% were due to abuse (physical, emotional or sexual), and 46% were due to any kind of household dysfunction. There is an increasing trend in ACEs in the United States. Adults with low socio-economic status, female, living in urban areas, gay or bisexual orientation, minority other than White and unemployed had a significantly higher prevalence of ACEs than their counterparts. ACEs were found to be significantly associated with poor physical and mental health; health-harming behaviours such as binge drinking, heavy drinking and smoking; and chronic morbidities. Conclusion: Programmes aimed at reducing ACEs and mitigating the harms of ACEs among those who have already experienced them should be strengthened to improve public health and quality of life and reduce health-harming behaviours.