Adverse childhood experiences and health care utilization in a low-income population

Margaret K. Hargreaves, Charles Mouton, Jianguo Liu, Yuan E. Zhou, William J. Blot

Research output: Contribution to journalArticle

Abstract

Objective. To determine associations of adverse childhood experiences (ACE) with adult health care utilization in an underserved, low-income population. Methods. Questionnaires on ACE were completed by 38,200 adults (mean age 54), two-thirds African American, recruited from community health centers (CHCs) across 12 Southeastern states. Odds ratios (ORs) and accompanying 95% confidence intervals (CIs) were computed. Results. The percentages reporting emergency room visits and doctor’s office visits, with high chronic disease index scores, rose monotonically (ptrend<.001) with rising ACE score. Odds ratios (CIs) for those with four or more vs. zero ACEs were 1.37 (95% CI 1.27-1.47) for 1-10 times and 1.80 (95% CI 1.29-2.52) for more than 10 times ER visits, 1.37 (95% CI 1.18-1.59) for over 10 doctor’s visits, and 2.29 (95% CI 2.06-2.54) for three or more chronic diseases. Conclusions. High ACE levels were associated with greater chronic disease burden and greater health care utilization in adulthood. Long-lasting effects from ACE on the health care of underserved populations are indicated. There is an urgent need to train health care providers, patients, and their families on ACE effects and treatments for better health care outcomes.

Original languageEnglish (US)
Pages (from-to)749-767
Number of pages19
JournalJournal of Health Care for the Poor and Underserved
Volume30
Issue number2
DOIs
StatePublished - May 1 2019

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Patient Acceptance of Health Care
Poverty
Confidence Intervals
Chronic Disease
Odds Ratio
Delivery of Health Care
Community Health Centers
Office Visits
Vulnerable Populations
African Americans
Health Personnel
Hospital Emergency Service

Keywords

  • Ace
  • Adverse childhood experiences
  • Health care utilization
  • Low-income population

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Adverse childhood experiences and health care utilization in a low-income population. / Hargreaves, Margaret K.; Mouton, Charles; Liu, Jianguo; Zhou, Yuan E.; Blot, William J.

In: Journal of Health Care for the Poor and Underserved, Vol. 30, No. 2, 01.05.2019, p. 749-767.

Research output: Contribution to journalArticle

Hargreaves, Margaret K. ; Mouton, Charles ; Liu, Jianguo ; Zhou, Yuan E. ; Blot, William J. / Adverse childhood experiences and health care utilization in a low-income population. In: Journal of Health Care for the Poor and Underserved. 2019 ; Vol. 30, No. 2. pp. 749-767.
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