Many studies have investigated the effects of adverse childhood experiences (ACEs) on the health, development, and well-being of children and adolescents. However, most studies have failed to examine whether childhood adversity and ecological factors interact to influence relevant health outcomes. We used pooled data from the 2018–19 National Survey of Children's Health ( = 24,817) to assess the relationship between ACEs, neighborhood quality, and three domains of adolescent health and well-being: mental health (i.e., symptoms of anxiety problems and depression), neurodevelopmental health, and behavioral problems. Nine types of ACEs were captured in the NSCH data. Logistic regression models were employed to explore the relationship between ACEs, neighborhood quality, and adolescent health and well-being. Our results indicate that ACEs are associated with each of these domains, with higher ACE scores associated with a higher risk of detrimental outcomes. Neighborhood disorder is also associated with several outcomes. Consistent with our expectations, in the presence of neighborhood disorder the association between higher ACEs exposure and behavior/conduct problems or neurodevelopmental disorders is larger. Our results have important implications for understanding how individual and contextual factors may combine to influence child health and behaviors, as well as offering policy recommendations that might help children who experience traumatic events.

中文翻译：

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不良童年经历和邻里质量对儿童健康和福祉的综合影响


许多研究调查了不良童年经历 (ACE) 对儿童和青少年健康、发展和福祉的影响。然而，大多数研究未能检验童年逆境和生态因素是否相互作用以影响相关的健康结果。我们使用 2018-19 年全国儿童健康调查 (= 24,817) 的汇总数据来评估 ACE、社区质量以及青少年健康和福祉的三个领域之间的关系：心理健康（即焦虑问题和抑郁的症状） ）、神经发育健康和行为问题。 NSCH 数据中捕获了九种类型的 ACE。采用逻辑回归模型来探讨 ACE、邻里质量以及青少年健康和福祉之间的关系。我们的结果表明，ACE 与这些领域中的每一个相关，ACE 分数越高，有害结果的风险越高。邻里关系混乱也与多种结果有关。与我们的预期一致，在存在邻里障碍的情况下，较高的 ACE 暴露与行为/品行问题或神经发育障碍之间的关联更大。我们的研究结果对于理解个人和背景因素如何结合起来影响儿童的健康和行为以及提供可能帮助经历创伤事件的儿童的政策建议具有重要意义。