Relationship between adverse childhood experiences and perceived discrimination in adulthood.

BACKGROUND: Adverse Childhood Experiences (ACEs) and perceived discrimination impact health overtime, however little is known about their association. METHODS: Data for 6,325 participants in the Midlife in the US (MIDUS) study were analyzed across three waves of data. ACEs included emotional or physical abuse, household dysfunction, or financial strain in childhood. Generalized Linear Models with Generalized Estimating Equation approach was used to test the unadjusted and adjusted associations for ACEs and perceived discrimination and perceived inequality. RESULTS: Individuals with ACEs reported significantly higher perceived inequality in work (ß=0.05, 95%CI 0.02-0.07), in home (ß=0.06, 95%CI 0.04-0.09), in family relationships (ß=0.09, 95%CI 0.06-0.11), perceived daily discrimination (ß=0.77, 95%CI 0.58-0.96), and perceived lifetime discrimination (ß=0.24, 95%CI 0.18-0.30). ACE types were significantly associated with more perceived inequality and perceived discrimination. . Abuse was independently associated with all outcomes after adjusting for household dysfunction, financial strain, age, sex, race/ethnicity, education, marital status, and income. LIMITATIONS: Findings cannot speak to the temporal relationship between ACEs and discrimination. It should not be assumed that ACEs cause perceived discrimination, but rather that there is an important association that warrants further investigation. CONCLUSIONS: These findings represent the first step in better understanding the relationship between ACEs and perceived discrimination. As both influence health across the lifespan, understanding the relationship, mechanisms, and pathways for intervening are of great importance from a population health perspective. Efforts to incorporate discussions on experiences with discrimination and inequality may be warranted as a part of treatment for ACEs to address psychosocial stressors across the lifespan.

The differential impact of adverse childhood experiences in the development of pre-diabetes in a longitudinal cohort of US adults.

BACKGROUND: ACEs have a dose-response relationship with diabetes. The relationship between ACEs and pre-diabetes is not well known and may represent an effective area for prevention efforts. METHODS: Data from 1054 participants from two waves of the longitudinal MIDUS study were used. Multivariate general linear regression models assessed the relationship between ACEs and biomarker outcomes. Correlation tests and mediation models investigated the relationship between ACE and pre-diabetes. RESULTS: Individuals reporting ACEs were statistically significantly more likely to have higher BMI (1.13 (0.34-1.92)), higher waist circumference (2.74 (0.72-4.76)), elevated blood fasting insulin levels (2.36 (0.71-4.02)) and higher insulin resistance (HOMA-IR (0.57 (0.08-1.06)). BMI/waist circumference and insulin resistance did not maintain independent relationships with ACEs once HOMA-IR was included in the dichotomized ACE model (p = 0.05 and p = 0.06, respectively), suggesting the relationship between BMI and ACEs may be mediated by insulin resistance. CONCLUSIONS: These results represent one of the first studies to examine the differential impact of ACEs on a diverse set of clinical pre-diabetes measures. Findings suggest sexual and physical abuse, and financial strain during childhood are important factors associated with higher risk for pre-diabetes, and should be considered during intervention development.