Introduction: Individuals who have had adverse childhood experiences (ACEs) tend to have more health problems as adults. They are also at higher risk of adopting health-risk behaviors, further increasing the risk of negative health outcomes and premature death. This study aimed to assess the associations between ACEs, health-related quality of life (HRQoL), health problems, and health-risk behaviors in adulthood according to the number and nature of ACEs among Iceland's general population.
Material and methods: This was a retrospective cross-sectional study among 12,400 individuals aged 18-80, randomly selected from Maskina's general population panel (Thjódgatt). Associations between variables were analyzed by chi-square test, logistic regression and ANOVA.
Results: The response rate was 44.8% (female 57.2%, M = 54.8 years). A total of 91.1% of participants answered the ACE questionnaire, of which 65.9% reported at least one ACE (≥1), and 17.7% reported four or more ACEs (≥4). There was a dose-response relationship between the number of ACEs and negative health outcomes, where increased ACE scores were associated with increased risks of health problems and health-risk behaviors. Four or more ACEs were associated with an increased risk of all negative health outcomes and lower HRQoL. Associations between ACEs and negative health outcomes varied depending on the nature of the ACEs.
Conclusion: Adverse childhood experiences are risk factors for various health problems in adulthood. With increased emphasis on prevention and trauma-informed care within the healthcare system and other key sectors of society, serious health and psychosocial consequences could be mitigated, reducing disease burden and improving public health.
Keywords: Adverse childhood experiences (ACEs); health problems; health-related quality of life (HRQoL); health-risk behaviors; stress.