マイ手帳大賞：記憶の定着には感動も大切です/医療福祉政策学会参加
Abstract
Background: The relationship of health risk behavior and disease in adulthood to the breadth of exposure to childhood emotional, physical, or sexual abuse, and household dysfunction during childhood has not previously been described.
Methods: A questionnaire about adverse childhood experiences was mailed to 13,494 adults who had completed a standardized medical evaluation at a large HMO; 9,508 (70.5%) responded. Seven categories of adverse childhood experiences were studied: psychological, physical, or sexual abuse; violence against mother; or living with household members who were substance abusers, mentally ill or suicidal, or ever imprisoned. The number of categories of these adverse childhood experiences was then compared to measures of adult risk behavior, health status, and disease. Logistic regression was used to adjust for effects of demographic factors on the association between the cumulative number of categories of childhood exposures (range: 0-7) and risk factors for the leading causes of death in adult life.
Results: More than half of respondents reported at least one, and one-fourth reported > or = 2 categories of childhood exposures. We found a graded relationship between the number of categories of childhood exposure and each of the adult health risk behaviors and diseases that were studied (P < .001). Persons who had experienced four or more categories of childhood exposure, compared to those who had experienced none, had 4- to 12-fold increased health risks for alcoholism, drug abuse, depression, and suicide attempt; a 2- to 4-fold increase in smoking, poor self-rated health, > or = 50 sexual intercourse partners, and sexually transmitted disease; and 1.4- to 1.6-fold increase in physical inactivity and severe obesity. The number of categories of adverse childhood exposures showed a graded relationship to the presence of adult diseases including ischemic heart disease, cancer, chronic lung disease, skeletal fractures, and liver disease. The seven categories of adverse childhood experiences were strongly interrelated and persons with multiple categories of childhood exposure were likely to have multiple health risk factors later in life.
Conclusions: We found a strong graded relationship between the breadth of exposure to abuse or household dysfunction during childhood and multiple risk factors for several of the leading causes of death in adults.
・で、上の文献見ていたらセカンド・オーサーが書いた似たようなお題の文献もありました↓
The relationship of adverse childhood experiences to a history of premature death of family members.
Anda RF, Dong M, Brown DW, Felitti VJ, Giles WH, Perry GS, Valerie EJ, Dube SR. BMC Public Health.
2009 Apr 16;9:106. doi: 10.1186/1471-2458-9-106.
https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-9-106
Abstract
Background: To assess the association between adverse childhood experiences (ACEs), including childhood abuse and neglect, and serious household dysfunction, and premature death of a family member. Because ACEs increase the risk for many of the leading causes of death in adults and tend to be familial and intergenerational, we hypothesized that persons who report having more ACEs would be more likely to have family members at risk of premature death.
Methods: We used data from 17,337 adult health plan members who completed a survey about 10 types of ACEs and whether a family member died before age 65. The prevalence of family member premature death and its association with ACEs were assessed.
Results: Family members of respondents who experienced any type of ACEs were more likely to have elevated prevalence for premature death relative to those of respondents without such experience (p < 0.01). The highest risk occurred among those who reported having been physically neglected and living with substance abusing or criminal family members during childhood. A powerful graded relationship between the number of ACEs and premature mortality in the family was observed for all age groups, and comparison between groups reporting 0 ACE and >or= 4 ACEs yielded an OR of 1.8 (95%CI, 1.6-2.0).
Conclusion: Adverse childhood experiences may be an indicator of a chaotic family environment that results in an increased risk of premature death among family members.
・上の文献サマリーしか読んでませんが、早いうちによめたらよいな。あと、これらの文献ひょっとしたら"social epidemiology"に引用されていないかしら．．．
・で、その後は庭の草刈りを１９時過ぎまで。なんと配偶者が私に触発されたのか天下のmakita様の電動草刈り機を購入しており、本日草刈りデビュー。プラスチックの歯だったみたいで今日だけですり切れてしまったと。で、汗だくになっており私を追い抜いて先にシャワー浴びておりました。その後私もシャワー浴びて、軽い夕食。ステラアルトア飲みました。それでもうグデングデンなので、明日に備えてもう寝ます。明日は午前中地域の草刈りです。熱中症にならないようにボツボツやります。（そのためにちょっとずつ周辺の草をかっていたのだから）
