Evidence map›Paper›PMID 40426152›Full record

ArticleBMC public health2025

The long-term effects of adverse childhood experiences on adult health and behaviors: mediating role of socioeconomic inequality.

Yanling Shu, Zheng Zhang, Hengyu Wang, Chunling Wang, Linfei Dou, Wenhua Wang, Lei Zhang, Jianing Bi, Mingyang Wu

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Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Yanling Shu *Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, China.
Zheng Zhang *Xiangya School of Medicine, Central South University, No.172, Tongzipo Road, Changsha, 410013, China.
Hengyu Wang *Department of Clinical Microbiology and Immunology, College of Pharmacy and Laboratory Medicine Science, Army Medical University, Gaotanyan Street No.30, Shapingba District, Chongqing, 400038, China.
Chunling WangAffiliated Rehabilitation Hospital of Nanchang University, Nanchang, China.
Linfei DouDepartment of Maternal and Child Health, Xiangya School of Public Health, Central South University, No.172 Tongzipo Road, Changsha, 410013, China.
Wenhua WangShaanxi Medical Association, Xi'an, China.
Lei ZhangShaanxi Medical Association, Xi'an, China.
Jianing BiDepartment of Health Statistics, School of Public Health, China Medical University, Shenyang, China.
Mingyang WuDepartment of Maternal and Child Health, Xiangya School of Public Health, Central South University, No.172 Tongzipo Road, Changsha, 410013, China. mingyangwu@csu.edu.cn.

Funding

Changsha Municipal Natural Science Foundation kq2208302Natural Science Foundation of Hunan Province 2023JJ40801
6 · The paper itself

Abstract

backgroundDespite extensive research into the health effects of adverse childhood experiences (ACEs), there remains a need for nationally representative data to assess the associations between ACEs and both adult health and behaviors, focusing on the mediating role of socioeconomic inequality.

methodUsing data from the 2019-2022 Behavioral Risk Factor Surveillance System (BRFSS) (N = 249,186 adults), ACE exposure was categorized into five groups (0, 1, 2, 3, and 4 or more ACEs). Socioeconomic inequality was assessed based on income levels. Binary logistic regression was employed to quantify the associations of ACEs/socioeconomic inequality with adult health and behaviors. Mediation models were used to evaluate the mediating effect of socioeconomic inequality on the relationships of continuous ACE scores with adult health and behaviors.

resultsEach unit increase in ACE score was associated with a 4-34% increase in the odds of adverse health outcomes or unhealthy behaviors. Compared to participants with no ACE exposure, those with ≥ 4 ACEs exhibited a higher likelihood of experiencing asthma, arthritis, cancer, cardiovascular disease (CVD), chronic obstructive pulmonary disease (COPD), diabetes, disability, depression, more days of poor physical and mental health, and engagement in drinking, smoking and high-risk HIV behavior, with odds ratios ranging from 1.26 (95% CI: 1.22-1.31) for diabetes to 4.87 (95% CI: 4.72-5.02) for depression. Socioeconomic inequality mediated more than 5% of associations between ACE scores and diabetes, disability, COPD, and CVD.

conclusionsThis study reveals a broad spectrum of negative health impacts associated with ACE exposure, with socioeconomic inequality demonstrating a significant mediating effect on these associations. The findings emphasize the need for public health interventions targeting both ACEs and socioeconomic inequality to alleviate the burden of chronic diseases and improve adult health conditions.

Indexed as

Adverse Childhood ExperiencesHealth BehaviorHealth Status DisparitiesSocioeconomic FactorsAdultAgedBehavioral Risk Factor Surveillance SystemFemaleHumansMaleMiddle AgedYoung AdultAdverse childhood experiencesBehaviorsMental healthPhysical healthSocioeconomic inequality

Identifiers

PMID40426152
PMCPMC12107932

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.