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Cited by 519Child Abuse and TraumaIntimate Partner and Family ViolenceChild Welfare and Adoption

Separate and cumulative effects of adverse childhood experiences in predicting adult health and health care utilization

Chartier, Mariette J., Walker, John R., Naimark, Barbara·2010·Child Abuse & Neglect
DOI 10.1016/j.chiabu.2009.09.020
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Abstract

Objectives Objectives of this population-based study were: (1) to examine the relative contribution of childhood abuse and other adverse childhood experiences to poor adult health and increased health care utilization and (2) to examine the cumulative effects of adverse childhood experiences on adult health and health care utilization.Methods Data from the Ontario Health Survey, a representative population sample (n=9,953) of respondents aged 15 years and older, were analyzed using logistic regression. Adverse childhood experiences examined were childhood physical and sexual abuse, parental marital conflict, poor parent-child relationship, low parental education and parental psychopathology.Results Most (72%) respondents reported at least one adverse childhood experience and a considerable proportion of respondents (37%) reported two or more of these experiences. In examining the bivariate models, childhood physical and sexual abuse had a stronger influence than other types of adverse childhood experiences. With the addition of other adverse childhood experiences in the model, the odds ratios for childhood abuse were attenuated but remained statistically significant for most health outcomes. This suggests that childhood abuse may have a unique adverse influence on the development of poor adult health. When an aggregate variable was created to explore the cumulative effects of adverse childhood experience, the odds were increased, with each additional experience, for reporting multiple health problems [odds ratio (OR): 1.22], poor self-rated health (OR: 1.18), pain (OR: 1.24), disability (OR: 1.24), general practitioner use (OR: 1.12), emergency room use (OR: 1.29) and health professional use (OR: 1.19).Conclusions This study suggests that childhood abuse and other adverse childhood experiences are overlapping risk factors for long-term adult health problems and that the accumulation of these adverse experiences increases the risk of poor adult health.Practice implications This study highlights the importance of the many adverse childhood experiences influencing long-term health. In practice, childhood abuse is often difficult to identify as families tend to keep it hidden and reported cases represent only a small percentage of the actual cases. Assessments and interventions which focus on improving socio-economic status, strengthening marital and parent-child relationships, and supporting parents with mental health issues are less threatening for families than assessing their experiences with abuse and neglect and are more likely to be effective in identifying and supporting at-risk families.

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  • The effects of trauma are cumulative; youth who experience a greater number of traumatic events are more at risk for adverse outcomes and more complex symptoms through adulthood.

    “Moreover, there is some evidence that the effects of trauma are cumulative, thus youth who experience a greater number of traumatic events are more at risk for adverse outcomes and more complex symptoms through adulthood (Chartier, Walker, & Naimark, 2010; Cloitre et al., 2009; Hodges et al., 2013).”

    From Effects of trauma-informed approaches in schools: A systematic review (2019) · cites this paper as Chartier et al., 2010

  • Parental mental illness and subsequent parenting behaviours contribute to increased risk of offspring developing medical and psychological disorders.

    “ACE literature has found that parental mental illness and subsequent parenting behaviours contribute to an increased risk of offspring developing a range of medical and psychological disorders (Anda et al. 2002;Chartier et al. 2010).”

    From The effects of paternal depression on child and adolescent outcomes: A systematic review (2016) · cites this paper as Chartier et al. 2010

  • Marital conflict is regarded as an adverse childhood experience that can lead to poorer development in children.

    “marital conflict can be considered an adverse childhood experience which may result in suboptimal development for offspring (Chartier et al. 2010).”

    From The effects of paternal depression on child and adolescent outcomes: A systematic review (2016) · cites this paper as Chartier et al. 2010

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Authors
Chartier, M. J., Walker, J. R., & Naimark, B.
Affiliations
University of Manitoba (CA)
Corresponding author
Chartier, Mariette J.
ORCID
Venue
Child Abuse & Neglect
Publisher
Elsevier BV
Published
2010-06
Volume
34
Issue
6
Pages
454-464
ISSN
0145-2134 (ISSN-L)
DOI
10.1016/j.chiabu.2009.09.020
OpenAlex
W2109548593
Cited by
519
References
69
Citations by year
2026: 16 · 2025: 17 · 2024: 36 · 2023: 37 · 2022: 46 · 2021: 54 · 2020: 45 · 2019: 60 · 2018: 33 · 2017: 32 · 2016: 38 · 2015: 36 · 2014: 26 · 2013: 24 · 2012: 9
FWCI
14.37
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Child Abuse & Neglect (publishedVersion)
  • PubMed (publishedVersion)
Funders
Canadian Institutes of Health Research
Topics
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
  • Social Sciences › Health › Intimate Partner and Family Violence
  • Social Sciences › Safety Research › Child Welfare and Adoption
Keywords
adverse childhood experiences, child physical abuse, child sexual abuse, cumulative effects, adult health, health care utilization, parental marital conflict, parent-child relationship, parental education, parental psychopathology, self-rated health, pain, disability, emergency department utilization, general practitioner use
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Child, Preschool, Female, Forecasting, Health Services, Health Status, Health Surveys, Humans, Male, Middle Aged, Ontario, Risk Factors, Logistic Models, Adult Survivors of Child Abuse, Family Conflict, Young Adult

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