Gender Differences in the Association Between Adverse Childhood Experiences and Health Risk Behaviors in the Mountain West.

Introduction: Recent evidence suggests that adults in the Mountain West region report a higher prevalence of adverse childhood experiences than the national level. Although the associations between adverse childhood experiences and adult health risk behaviors, such as smoking and problematic alcohol use, are well established, it is unclear whether those associations vary by gender. Applying a gendered life-course perspective, this study examines the associations between adverse childhood experiences and adult health risk behaviors. Methods: This cross-sectional study analyzed data from the 2020 Behavioral Risk Factor Surveillance System from 6 Mountain West states using Poisson regression models. Results: Of the 40,795 participants, 69% reported the prevalence of at least 1 adverse childhood experience. Women had a higher prevalence of experiencing sexual abuse, living with a household member with mental illness, and living with a household member with substance use disorders than their male counterparts. Women also reported significantly more exposure to adverse childhood experiences on average than men. Although women in general reported a significantly lower prevalence of adult health risk behaviors than men, with every 1-unit increase in adverse childhood experience score, women had a significantly higher prevalence of ever smoking and binge drinking than men (adjusted prevalence ratio=1.04, 95% CI=1.02, 1.06 and adjusted prevalence ratio=1.10, 95% CI=1.06, 1.15, respectively). Conclusions: The relationship between adverse childhood experiences and adult health risk behaviors varies by gender. Therefore, the findings support gender-responsive prevention measures for adverse childhood experiences and the implementation of intervention programs to minimize adult health risk behaviors in the Mountain West region.