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

Details

• Alternative Title:
  Int J Chron Obstruct Pulmon Dis
• Personal Author:
  Cunningham, Timothy J. ; Ford, Earl S. ; Croft, Janet B. ; Merrick, Melissa T. ; Rolle, Italia V. ; Giles, Wayne H.
• Description:
  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.
  
  
• Subjects:
  Adolescent Adult Aged Child Abuse, Sexual Divorce Domestic Violence Female Humans Life Change Events Linear Models Male Mental Disorders Middle Aged Prevalence Pulmonary Disease, Chronic Obstructive Pulmonary Disease, Chronic Obstructive/psychology Residence Characteristics Risk Factors Sex Factors Substance-Related Disorders Young Adult

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• Source:
  Int J Chron Obstruct Pulmon Dis. 2014; 9:1033-1043.
• Document Type:
  Journal Article
• Place as Subject:
  United States
• Volume:
  9
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:c0ebd32efd3f8c3878550174fa6462a4563a293abf03701c0af56c9e191c0b9a
• Download URL:
  https://stacks.cdc.gov/view/cdc/25561/cdc_25561_DS1.pdf
• File Type:
  [PDF - 331.89 KB ]