Prevalence and Impact of Adverse Childhood Experiences in the Hispanic Community by Questionnaire Language Preference: Behavioral Risk Factor Surveillance System (BRFSS) 2011, 2012
Creators: name: Alhalel, Nathan
Publisher: name: DigitalHub. Galter Health Sciences Library & Learning Center
Year: 2018
Subjects: subject: hispanics
subject: adverse childhood experiences
subject: language preferences
subject: risk factor surveillance
subject: Adverse Childhood Experiences
subject: Hispanic or Latino
subject: Behavioral Risk Factor Surveillance System
subject: Language
subject: Self Report
subject: United States

description: Objective: The study analyzes the prevalence of Adverse Childhood Experiences (ACEs) in the Hispanic population of nine states, using 2011-2012 Behavioral Risk Factor Surveillance System (BRFSS).  The study compares ACEs prevalence and adult self-reported health status, chronic conditions, and behavioral risk factors by English versus Spanish survey language.Methods:. BRFSS data are weighted estimates that reflect state level populations.  ACEs were compared  by questionnaire language preference and by respondent sociodemographic characteristics. Self-reported health status, behavioral risk factors and chronic conditions were dichotomized into adverse adult health outcomes and compared across four categories of ACEs score (0, 1, 2-3, 4+). Chi square tests were used to determine the statistical significance of language preference differences in individual ACE items and sociodemographic characteristics.  Multiple logistic regression, adjusted for differences in language preference within each level of ACEs score, was used to analyze the likelihood of adverse adult health outcomes independently associated with language preference across all ACE score categories.  Results: From over 68,000 respondents 2,983 affirmed being Hispanic or Latino, representing a weighted population of 1,855,212. For the overall cohort and both language preference groups, respondents ages 35 to 49, women, and the uninsured reported the highest percentage of 4+ ACEs. Verbal abuse was the most common adverse childhood experience reported (27.2%) while being forced to have sex was the least common (4.9%). The prevalence of the majority of individual adverse childhood experiences differed significantly between the English and Spanish questionnaire preference groups (p<0.01). Reporting 4+ ACEs was associated with an elevated prevalence of disability, cancer, COPD, asthma, depression, smoking, and heavy drinking but not diabetes, self-reported, physical, mental, and general health, and  in the overall cohort. Differences between the English and Spanish  4+ ACE groups included higher odds of having cancer, having smoked, and being a heavy drinking among English preference respondents and higher odds of poor or fair general health, cardiovascular disease and COPD among those that preferred Spanish.Conclusions: There were substantial differences in both ACEs prevalence by BRFSS language preference and in both populations there was a strong association between effects of ACEs score on adult health outcomes. The superior health status of Spanish language respondents, a younger, healthier population, may in part correspond to differences in immigrant health, or as described in terms of cultural differences, acculturation. However, it is important to note that the nine states studied reflect smaller, more isolated Hispanic communities than those of high Hispanic population states usually studied. The greatest association between high ACEs score and bad health outcomes was seen among English survey language survey respondents with the highest ACE score. Public health and medical professionals are trying to address childhood adversity as we better understand how it is a root cause for many negative adult health conditions.  Approaches to universal screening by pediatricians and trauma informed care for adults are evolving.