TY - JOUR
T1 - Adverse childhood experiences and adult cardiometabolic risk factors and disease outcomes
T2 - Cross-sectional, populationbased study of adults in rural Uganda
AU - Kim, Andrew Wooyoung
AU - Kakuhikire, Bernard
AU - Baguma, Charles
AU - North, Crystal M.
AU - Satinsky, Emily N.
AU - Perkins, Jessica M.
AU - Ayebare, Patience
AU - Kiconco, Allen
AU - Namara, Elizabeth B.
AU - Bangsberg, David R.
AU - Siedner, Mark J.
AU - Tsai, Alexander C.
N1 - Funding Information:
[R01MH113494 and R01MH125667]. AWK is supported by a US National Science Foundation Graduate Research Fellowship and the Fogarty International Center and National Institute of Mental Health [NIH D43TW010543]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Funding Information:
We thank the HopeNet cohort study participants, without whom this research would not be possible. We also thank members of the HopeNet study team for research assistance. In addition to the named study authors, HopeNet Study team members who contributed to data collection and/or study administration during all or any part of the study were as follows: Phiona Ahereza, Owen Alleluya, Dickson Beinomugisha, Bridget Burns, Patrick Gumisiri-za, Mercy Juliet, Clare Kamagara, Justus Kananura, Viola Kyokunda, Godfrey Massette, Patrick Lukwago Muleke, Rhina Mushagara, Rumbidzai Mushavi, Elijah Musinguzi, Immaculate Ninsiima, Moran Owembabazi, Mellon Tayebwa, Ezra Turinanwe, Julius Turyasingura, and Dagmar Vorechovska. We also thank Roger Hofmann of West Portal Software Corporation (San Francisco, CA, USA), for developing and customizing the CASIC Builder software program used for survey administration. No endorsement of manuscript contents or conclusions should be inferred from these acknowledgments.
Publisher Copyright:
© 2021 The Author(s). All Rights Reserved.
PY - 2021
Y1 - 2021
N2 - Background Cardiovascular diseases (CVD) pose a major threat to public health in sub-Saharan African communities, where the burden of these classes of illnesses is expected to double by 2030. Growing research suggests that past developmental experiences and early life conditions may also elevate CVD risk throughout the life course. Greater childhood stress and adversity are consistently associated with a range of adult CVDs and associated risk factors, yet little research exists on the long-term effects of early life stress on adult physical health outcomes, especially CVD risk, in sub-Saharan African contexts. This study aims to evaluate the associations between adverse childhood experiences and adult cardiometabolic risk factors and health outcomes in a population-based study of adults living in Mbarara, a rural region of southwestern Uganda. Methods Data come from an ongoing, whole-population social network cohort study of adults living in the eight villages of Nyakabare Parish, Mbarara. A modified version of the Adverse Childhood Experiences-Interna-tional Questionnaire (ACEs) assessed past exposure to physical, emotional, and sexual adversity. Participants also took part in a health fair where medical histories on cardiometabolic risk factors and cardiovascular diseases were gathered. Multiple logistic regression models estimated the associations between ACEs and car-diometabolic risk factors and health outcomes. Results Data were available on 545 adults. The average number of ACEs was 4.9 out of a possible 16. The cumulative number of ACEs were associated with having a history of heart attack and/or heart failure (adjusted odds ratio (AOR) = 1.11, 95% confidence interval (CI) = 0.999-1.234, P = 0.051), but the estimated association was not statistically significant. ACEs did not have statistically significant associations with any others measures of adult cardiometabolic risk and CVD. Conclusions Adverse childhood experiences are not associated with a range of adult cardiometabolic risk factors and health outcomes in this sample of rural Ugandan adults. Further research in this sample is necessary to identify the pathways that may motivate these null relationship and possibly protect against adverse cardiometabolic and cardiovascular health outcomes.
AB - Background Cardiovascular diseases (CVD) pose a major threat to public health in sub-Saharan African communities, where the burden of these classes of illnesses is expected to double by 2030. Growing research suggests that past developmental experiences and early life conditions may also elevate CVD risk throughout the life course. Greater childhood stress and adversity are consistently associated with a range of adult CVDs and associated risk factors, yet little research exists on the long-term effects of early life stress on adult physical health outcomes, especially CVD risk, in sub-Saharan African contexts. This study aims to evaluate the associations between adverse childhood experiences and adult cardiometabolic risk factors and health outcomes in a population-based study of adults living in Mbarara, a rural region of southwestern Uganda. Methods Data come from an ongoing, whole-population social network cohort study of adults living in the eight villages of Nyakabare Parish, Mbarara. A modified version of the Adverse Childhood Experiences-Interna-tional Questionnaire (ACEs) assessed past exposure to physical, emotional, and sexual adversity. Participants also took part in a health fair where medical histories on cardiometabolic risk factors and cardiovascular diseases were gathered. Multiple logistic regression models estimated the associations between ACEs and car-diometabolic risk factors and health outcomes. Results Data were available on 545 adults. The average number of ACEs was 4.9 out of a possible 16. The cumulative number of ACEs were associated with having a history of heart attack and/or heart failure (adjusted odds ratio (AOR) = 1.11, 95% confidence interval (CI) = 0.999-1.234, P = 0.051), but the estimated association was not statistically significant. ACEs did not have statistically significant associations with any others measures of adult cardiometabolic risk and CVD. Conclusions Adverse childhood experiences are not associated with a range of adult cardiometabolic risk factors and health outcomes in this sample of rural Ugandan adults. Further research in this sample is necessary to identify the pathways that may motivate these null relationship and possibly protect against adverse cardiometabolic and cardiovascular health outcomes.
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U2 - 10.7189/jogh.11.04035
DO - 10.7189/jogh.11.04035
M3 - Article
C2 - 34386213
AN - SCOPUS:85106369561
SN - 2047-2978
VL - 11
SP - 1
EP - 8
JO - Journal of Global Health
JF - Journal of Global Health
ER -