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Childhood Adversity and its Effects on Health Over the Lifespan: Analysis of the Allegheny County Health Survey

Bear, Todd M (2014) Childhood Adversity and its Effects on Health Over the Lifespan: Analysis of the Allegheny County Health Survey. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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It has been estimated that 75% of the U.S. adult population has experienced some type of childhood adversity (CA), such as child maltreatment, parental divorce or violence and evidence continues to mount that exposure to such adversities can lead to serious mental and physical health consequences that extend well into late life. The life course perspective (LCP) is a theoretical perspective often used to explain how early life exposures influence health and behavior across the lifespan. Using the LCP and secondary data collected from the 2009-2010 Allegheny County Health Survey (N=5442), this study describes the prevalence and disparities in CA in terms of social, demographic, and geographic characteristics. A series of bivariate and multivariate logistic regressions are conducted to determine which adult health indicators (e.g., smoking, perceived social support, serious mental illness, cancer, cardiovascular disease) are most associated with CA and to what extent the prevalence of these health issues could be reduced if CA was prevented or eliminated. Furthermore, social, behavioral, and environmental pathways are evaluated in statistical models to determine which factors moderate and mediate the relationship between CA and adult health and behavior. Results indicate that CA is prevalent in the adult population of Allegheny County, Pennsylvania with an estimated 59.8% reporting at least one adverse childhood event. CA disparities were observed by gender, race, socioeconomic status, unemployment status and disability status. Population Attributable Risk (PAR) fractions were calculated and revealed that approximately 42% of serious mental illness and 26% of cardiovascular disease in the population could be eliminated if ACEs were prevented. Social and behavioral factors that mediate the CA adult health relationships included adult socioeconomic status, social support, smoking, and body mass index. The effects of CA on adult health appeared stronger and more independent for mental health outcomes than physical health outcomes. For those at-risk of and those who have experiencing CA, programs and policies that increase resources, teach positive strategies for coping with stress, and help families to increase their human and social capital may greatly reduce adult morbidly associated with CA and help to reduce current and intergenerational CA disparities by race and socioeconomic status.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Bear, Todd Mtobst2@pitt.eduTOBST2
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairDocumét, Patriciapdocumet@pitt.eduPDOCUMET
Committee MemberMarshal, Michael Pmarshalmp@upmc.eduMPM1
Committee MemberRicci, Edmund Memricci@pitt.eduEMRICCI
Committee MemberVoorhees,
Date: 29 January 2014
Date Type: Publication
Defense Date: 22 November 2013
Approval Date: 29 January 2014
Submission Date: 21 November 2013
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 136
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Behavioral and Community Health Sciences
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Childhood Adversity Life Course Perspective Adult Health
Date Deposited: 29 Jan 2014 17:18
Last Modified: 19 Dec 2016 14:41


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