Population attributable fractions of adolescent health and well-being outcomes associated with adverse childhood experiences in a provincially representative sample in Ontario, Canada

Abstract

Background

It is well known that Adverse Childhood Experiences (ACEs) are associated with poor health and well-being outcomes among adult samples. However, there are notable gaps in examining these relationships among youth.

Objective

The objectives were to examine: a) the prevalence of an expanded list of ACEs among adolescents, b) ACEs sex differences, c) associations between ACEs and several adolescent health and at-risk behavioural outcomes, and d) the population attributable fractions (PAFs) for three ACE groupings (i.e., child maltreatment, household challenges, and peer victimization).

Study design

Cross-sectional.

Participants and setting

Data were from the provincially-representative, cross-sectional 2014 Ontario Child Health Study (N = 6537 dwellings, response rate = 50.8%). One randomly selected child aged 14–17 years old (n = 2910) from each household was included.

Methods

The majority of measures (nine ACEs and six health and well-being outcomes) were self-reported (three household challenges ACEs and physical health were collected from parents/caregivers). Descriptive statistics estimated the prevalence of ACEs for the sample and by sex. Logistic regressions tested associations between individual ACEs and seven outcomes. Population attributable fractions (PAFs) were computed for three ACE groupings with each outcome.

Findings

ACEs prevalence ranged from 1.8% to 47.4% with several noted sex differences. Each ACE was associated with four or more studied outcomes. PAFs ranged from 3.5% to 47.8%, varying for each ACEs grouping.

Conclusion

The significant associations and estimated proportions of poor adolescent outcomes attributed to ACEs indicate that identifying approaches aimed at preventing these experiences could have a substantial impact on youth health and well-being.