Adverse childhood experiences and access and utilization of health care

J Public Health (Oxf). 2018 Dec 1;40(4):684-692. doi: 10.1093/pubmed/fdx155.

Abstract

Background: Adverse childhood experiences (ACEs) have been associated with a variety of negative health outcomes. However, the association between ACEs and access and utilization of health care have been largely ignored.

Methods: This study examined data from the 2011 Behavioral Risk Factor Surveillance System (N = 101 527). We conducted logistic regression analyses, with nine ACEs as independent variables, in relation to the odds of being insured, having a personal health care provider and receiving a physician checkup in the past year. Unadjusted and adjusted multivariable models were estimated.

Results: After accounting for potential confounders, all ACEs were associated with lower odds of being currently insured and receiving a physician checkup in the past year. Physical abuse, emotional abuse and several measures of household dysfunction were associated with lower odds of having a personal provider.

Conclusions: Our findings suggest potential pathways by which ACEs may impact health. Provision of health insurance and providing care in a trauma-informed manner should be considered for individuals with a history of ACEs.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adverse Childhood Experiences* / statistics & numerical data
  • Behavioral Risk Factor Surveillance System
  • Female
  • Health Services Accessibility* / statistics & numerical data
  • Humans
  • Insurance, Health / statistics & numerical data
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care* / statistics & numerical data
  • Regression Analysis
  • Risk Factors
  • United States