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      Adverse Childhood Experiences, Other Psychosocial Sources of Adversity, and Quality of Life in Vulnerable Primary Care Patients

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          Abstract

          Introduction

          Adults who had adverse childhood experiences (ACEs) have increased risk of negative health outcomes. Despite the prevalence of ACEs, literature is scarce on quality of life (QOL) and ACEs in disadvantaged primary care populations.

          Objective

          To examine the prevalence of ACEs and association with chronic health problems and QOL in disadvantaged primary care patients in Oklahoma.

          Methods

          During a primary care visit, adults completed a questionnaire measuring demographics, ACEs, current health status and well-being, sources of support and adversity, and QOL. A physician investigator reviewed participants’ health records, recording the incidence of 32 diagnoses commonly associated with chronic health problems.

          Results

          The survey was completed by 354 patients. Forty-three percent received disability benefits and 71% were unemployed. More than 37% reported 4 or more ACEs, and 35.5% had 0 or 1 ACE.The amount of health problems ranged from 0 to 11 and increased with the number of reported ACEs. The mean number of health problems for each ACE level was as follows: ACEs 0 to 1 had 3.01 problems (95% confidence interval = 2.96–3.88), ACEs 2 to 3 had 3.42 problems (95% confidence interval = 2.96–3.88), and ACEs 4 and above had 4.18 problems (95% confidence interval = 3.72–4.64). ACEs were significantly related to QOL.

          Conclusion

          This disadvantaged primary care population had high numbers of ACEs. ACEs correlated with increasing numbers of health problems and worse QOL. Enhanced awareness and action are needed to reduce health disparities and improve outcomes in similar populations.

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          Author and article information

          Journal
          Perm J
          Perm J
          prjl
          The Permanente Journal
          The Permanente Journal
          1552-5767
          1552-5775
          2020
          11 December 2019
          : 24
          Affiliations
          [1 ]Department of Internal Medicine, University of Oklahoma School of Community Medicine, Tulsa
          [2 ]Department of Family and Community Medicine, University of Oklahoma School of Community Medicine, Tulsa
          [3 ]Anne and Henry Zarrow School of Social Work, University of Oklahoma, Tulsa
          [4 ]Department of Psychiatry, University of Oklahoma School of Community Medicine, Tulsa
          Author notes
          Corresponding Author: Julie Miller-Cribbs, MSW, PhD ( jmcribbs@ 123456ou.edu )
          Article
          PMC6972546 PMC6972546 6972546 18.277
          10.7812/TPP/18.277
          6972546
          31905334
          © 2020 The Permanente Journal
          Categories
          Original Research & Contributions

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