Abstract
BackgroundAdverse Childhood Experiences (ACEs) have been linked to an increased risk of health and social problems throughout life. Studies on gender differences from developing countries are scarce. In this paper, we will examine gender variations in the types of reported ACEs and gender-specific relationships between cumulative ACEs and physical and mental health, and Risky Health Behaviors (RHB) in adulthood in the Kingdom of Saudi Arabia (KSA).MethodsA cross sectional national study was conducted in all of the 13 regions in KSA in 2013 using the ACE- International Questionnaire (ACE-IQ). We used multivariate logistic regression to examine the relationship between 4 + ACEs and physical, mental health and RHBs for both men and women separately after adjusting for age, education, marital status and current employment.ResultsThe total number of participants was 10,156 and women comprised 48% of the sample. The majority of respondents (80%) reported at least one ACE. Women had higher percentages of < =2 ACEs (65% vs 55%; p <0.05) while men were more likely to have 4+ ACEs (33% vs 25%; p < 0.05). When compared to participants with 0 ACE, men who reported 4+ ACEs were associated with the highest likelihood of using drugs (OR = 9.7; 95% CI: 6.4-14.5) and drinking alcohol (OR = 9.2; 95% CI: 6.3-13.6). On the other hand, women who experienced 4+ ACEs were associated with the highest likelihood of depression (OR = 7.0; 95% CI: 5.2-9.4), anxiety (OR = 6.4; 95% CI: 5.0-8.2) and other mental illnesses (OR = 7.4; 95% CI: 5.2-10.6). As for chronic diseases, abused men and women in childhood showed similarly a twofold increased risk of developing diabetes, hypertension, coronary heart disease and obesity when compared to non-abused participants.ConclusionFindings highlight the need to consider gender specific differences in the development of preventive strategies to address ACEs in KSA.
Highlights
Adverse Childhood Experiences (ACEs) have been linked to an increased risk of health and social problems throughout life
The lifetime cost for each surviving victim of child maltreatment is estimated to be US$210,012, which is comparable to other costly health conditions such as type 2 diabetes, the cost of which is estimated to be between US$181,000 and US$253,000, according to a report published by the Centers for Disease Control and Prevention (CDC) [9]
Sample and procedure In 2013, a cross-sectional study was conducted in all regions/provinces of Kingdom of Saudi Arabia (KSA) to identify the prevalence of ACEs and their association with health risk behaviors and chronic diseases among adults aged 18 years or above
Summary
Adverse Childhood Experiences (ACEs) have been linked to an increased risk of health and social problems throughout life. Adverse Childhood Experiences (ACEs) refer to some of the most intensive and frequently occurring sources of stress that children may suffer early in life [1]. Such experiences include multiple types of abuse, neglect, witnessing parental violence, and peer, community, and collective violence. Traumatic experiences in childhood have life-long consequences and can disrupt early brain development and increase the risk of a range of physical and mental health disorders [3]. The lifetime cost for each surviving victim of child maltreatment is estimated to be US$210,012, which is comparable to other costly health conditions such as type 2 diabetes, the cost of which is estimated to be between US$181,000 and US$253,000, according to a report published by the Centers for Disease Control and Prevention (CDC) [9]
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