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Child Abuse, Adversity Associated With Poor Health and Employment Outcomes Later in Life

PITTSBURGH, Nov. 18, 2014 – People who currently fall into low-income and educational brackets are up to five times as likely to have faced abuse and adversity during childhood as people who fall into higher socioeconomic groups, according to a University of Pittsburgh Graduate School of Public Health analysis of Allegheny County residents.
 
The findings, which will be presented Tuesday at the American Public Health Association’s (APHA) annual meeting in New Orleans, support the merit of “whole family” programs that seek to break the cycle of adversity and negative health, economic and social outcomes that persist over generations.
 
Eliminating childhood abuse and adversity significantly improves health – reducing heart disease by more than 26 percent and serious mental illness by more than 41 percent, the research team determined in a separate study presented Monday.
 
“Early childhood is a sensitive period of human development when abuse or parental problems can create lasting negative consequences later in life,” said lead investigator Todd M. Bear, Ph.D., director of the Office of Health Survey Research in Pitt Public Health’s Department of Behavioral and Community Health Sciences. “Our findings provide strong evidence that it is worthwhile for communities to invest in robust intervention programs that provide treatment, educational and employment opportunities, and positive role models to the whole family.”
 
The analyses used data from the 2009-2010 Allegheny County Health Survey, which interviewed 5,442 randomly selected residents of the county containing Pittsburgh.
 
Dr. Bear and his colleagues focused on six adverse childhood events reported by adult residents as having happened in their household when they were children: physical, sexual and emotional abuse, parental mental illness, parental substance abuse and domestic violence.
 
The research team, which included experts in epidemiology and psychiatry, found that:
 
  • Blacks had 2.5 times higher prevalence of childhood sexual abuse and greater rates of physical abuse when compared with whites.
  • People with a low socioeconomic status had 1.7 to 4.2 times higher prevalence for each of the six adverse childhood events compared with people of higher socioeconomic status.
  • People who reported they were unable to work also reported a prevalence of sexual abuse five times higher than those reporting employment.
The results are consistent with those of similar surveys conducted in other communities nationwide.
 
“We’ve found nothing to indicate that our findings are unique to Allegheny County,” said Dr. Bear. “These strong links between childhood adversity and poor socioeconomic status later in life, coupled with our findings that eliminating childhood abuse significantly prevents serious health consequences in adulthood, should be useful information for communities nationwide that are determining appropriate interventions to help their most vulnerable populations.”
 
Additional researchers on both these studies are Patricia I. Documét, M.D., Dr.P.H., Michael Marshal, Ph.D., Ronald Voorhees, M.D., M.P.H., and Edmund Ricci, Ph.D., M.Litt., all of Pitt.
 
APHA Abstract No. 309381, “Childhood adversity: A social determinant of health and inequity over the lifespan and across generations,” will be given as an oral presentation at 12:45 p.m. CST on Tuesday, Nov. 18, 2014.
 
APHA Abstract No. 311452, “Population attributable fractions of cardiovascular disease and serious mental illness associated with childhood adversity,” will be given as a poster presentation at 12:30 p.m. CST on Monday, Nov. 17, 2014.

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