Journal Article

Gender-based disparities in the impact of adverse childhood experiences on adult health: findings from a national study in the Kingdom of Saudi Arabia

Almuneef, Maha, Al-Eissa, Majid, ElChoueiry, Nathalie, Saleheen, Hassan N.

2017

Overview

Background Adverse Childhood Experiences (ACEs) have been linked to an increased risk of health and social problems throughout life. Studies on gender differences from developing countries are scarce. In this paper, we will examine gender variations in the types of reported ACEs and gender-specific relationships between cumulative ACEs and physical and mental health, and Risky Health Behaviors (RHB) in adulthood in the Kingdom of Saudi Arabia (KSA). Methods A cross sectional national study was conducted in all of the 13 regions in KSA in 2013 using the ACE- International Questionnaire (ACE-IQ). We used multivariate logistic regression to examine the relationship between 4 + ACEs and physical, mental health and RHBs for both men and women separately after adjusting for age, education, marital status and current employment. Results The total number of participants was 10,156 and women comprised 48% of the sample. The majority of respondents (80%) reported at least one ACE. Women had higher percentages of < =2 ACEs (65% vs 55%; p <0.05) while men were more likely to have 4+ ACEs (33% vs 25%; p  < 0.05). When compared to participants with 0 ACE, men who reported 4+ ACEs were associated with the highest likelihood of using drugs (OR = 9.7; 95% CI: 6.4-14.5) and drinking alcohol (OR = 9.2; 95% CI: 6.3-13.6). On the other hand, women who experienced 4+ ACEs were associated with the highest likelihood of depression (OR = 7.0; 95% CI: 5.2-9.4), anxiety (OR = 6.4; 95% CI: 5.0-8.2) and other mental illnesses (OR = 7.4; 95% CI: 5.2-10.6). As for chronic diseases, abused men and women in childhood showed similarly a twofold increased risk of developing diabetes, hypertension, coronary heart disease and obesity when compared to non-abused participants. Conclusion Findings highlight the need to consider gender specific differences in the development of preventive strategies to address ACEs in KSA.

• Publisher: BioMed Central,Springer Nature B.V,BMC
• Subject: Abused women / Adult / Adult Survivors of Child Adverse Events - psychology / Adult Survivors of Child Adverse Events - statistics & numerical data / Adverse childhood experiences / Age / Alcohol / Alcohol abuse / Alcohol use / Alcoholic beverages / Anxiety / Blood pressure / Cardiovascular disease / Cardiovascular diseases / Child abuse & neglect / Childhood / Childhood experiences / Childhood factors / Children / Chronic Disease - epidemiology / Chronic illness / Chronic illnesses / Confidentiality / Coronary artery disease / Cross-Sectional Studies / Demographics / Developing countries / Diabetes / Diabetes mellitus / Disease / Divorce / Domestic violence / Drinking / Drinking behavior / Drug abuse / Drugs / Education / Emotional abuse / Employment / Equality and Human Rights / Female / Gender / Gender aspects / Gender differences / Gender inequality / Health behavior / Health disparities / Health Policy / Health Promotion and Disease Prevention / Health Risk Behaviors / Health risks / Health Services Research / Health status / Health Status Disparities / Heart diseases / Humans / Hypertension / Illnesses / Imprisonment / Intelligence tests / Kingdom of Saudi Arabia / LDCs / Male / Marital status / Medicine / Medicine & Public Health / Men / Mental depression / Mental disorders / Mental Disorders - epidemiology / Mental health / Mental health care / Mental health problems / Obesity / Prevention / Public Health / Regression / Respondents / Risk / Risk behavior / Saudi Arabia - epidemiology / Secondary schools / Sex crimes / Sex differences / Sex Distribution / Smoking / Social behavior / Social conditions / Social Justice / Social Policy / Social problems / Stress / Studies / Substance abuse / Teenagers / Variables / Women / Womens health / Xenografts / Young adults