Association of Adverse Childhood Experiences with Self-rated Health among Chinese Elderly People

Abstract

Background The association of adverse childhood experiences (ACEs) with chronic disease prevalence among middle-aged and elderly people has become a research hot spot, but the association between ACEs and self-rated health in older people is still unclear, and relevant studies in Chinese population are especially rare. Objective To explore self-rated health in Chinese elderly people, and its association with ACEs. Methods The study was conducted in October 2021. Data about ACEs and self-rated health were acquired by applying from the 2014 and 2018 waves of CHARLS conducted by Peking University, involving 7 579 older people (≥ 60 years old) . The ACEs were stratified into three groups by the times of ACEs events (10 kinds in total) : high-risk (4 or more) , low-risk (1-3) , and reference (zero) . The self-rated health was divided into three levels: good, fair and poor. Ordinal logistic regression was used to analyze the correlation of self-rated health with the number and types of ACEs events. Results Among the participants, the prevalence of good, fair and poor self-rated health was 22.06% (1 672/7 579) , 59.03% (4 474/7 579) , and 18.91% (1 433/7 579) , respectively, and the prevalence of experiencing ≥4, 1-3 and no ACEs events was 25.36% (1 922/7 579) , 69.71% (5 283/7 579) , and 4.93% (374/7 579) , respectively. The self-rated health differed significantly by age, gender, place of living, and types of ACEs (parental divorce, parental violence, parental depression, parental disability, living in an unsafe neighborhood, childhood loneliness, childhood famishment, bullying) (P<0.05) . The self-rated health also differed significantly across the three groups stratified by the number of ACEs events (P<0.05) . Univariate ordinal logistic regression analysis indicated that the probability of a worse self-rated health increased by a factor of 1.358〔95%CI (1.110, 1.663) 〕in those with 1-3 ACEs events, and increased by a factor of 2.151 in those with 4 or more ACEs events compared with those with no ACEs events (P<0.05) . The ordinal Logistic regression analysis indicated that results showed that parental divorce, parental violence, parental depression, parental disability, living in an unsafe neighborhood, childhood loneliness, childhood famishment, and bullying were associated a worse self-rated health (P<0.05) . The statistical results remained unchanged after adjusting for age, gender and place of living. Conclusion The self-rated health status in Chinese older people was generally fair. To improve the self-rated health to promote healthy aging in this population, interventions could be provided for them targeting reducing the negative influence caused by parental divorce, parental violence, parental depression and disability, living in an unsafe neighborhood, childhood loneliness, and childhood famishment.

Keywords

• aged|adverse childhood experiences|geriatric assessment|charls database|root cause analysis