title: Adverse childhood experiences (ACE) and health-risk behaviors among adults in a developing country setting.
abstract: OBJECTIVE
  This study aimed to examine the association among adverse childhood experiences, health-risk behaviors, and chronic disease conditions in adult life.
  
  
  METHODS
  One thousand and sixty-eight (1,068) males and females aged 35 years and older, and residing in selected urban communities in Metro Manila participated in the cross-sectional survey.
  
  
  METHODS
  A pretested local version of the Adverse Childhood Experiences Questionnaires developed by the Centers for Disease Control and Prevention, USA, was used. Data were collected through self-administration of the questionnaire. Prevalence and estimates of odds ratio were computed to obtain a measure of association among variables. Logistic regression analysis was employed to adjust for the potential confounding effects of age, sex, and socio-economic status.
  
  
  RESULTS
  The results indicated that 75% of the respondents had at least 1 exposure to adverse childhood experiences. Nine percent had experienced 4 or more types of abuse and household dysfunctions. The most commonly reported types of negative childhood events were psychological/emotional abuse, physical neglect, and psychological neglect of basic needs. Majority of respondents claimed to have experienced living with an alcoholic or problem drinker and where there was domestic violence. Health-risk behavior consequences were mostly in the form of smoking, alcohol use, and risky sexual behavior. The general trend shows that there was a relatively strong graded relationship between number of adverse childhood experiences, health-risk behaviors, and poor health.
  
  
  CONCLUSIONS
  This study provided evidence that child maltreatment is a public health problem even in poorer environments. Prevention and early intervention of child maltreatment were recommended to reduce the prevalence of health-risk behavior and morbidity in later life.
authors.affiliation: Department of Behavioral Sciences, College of Arts and Sciences, University of the Philippines Manila, Padre Faura st., Ermita, Manila, Philippines.
authors.forename: Laurie S
authors.initials: LS
authors.lastname: Ramiro
authors.forename: Bernadette J
authors.initials: BJ
authors.lastname: Madrid
authors.forename: David W
authors.initials: DW
authors.lastname: Brown
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002649:Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data*; D002908:Chronic Disease / Q000453:epidemiology / Q000523:psychology; D002958:City Planning; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010679:Philippines / Q000453:epidemiology; D012309:Risk-Taking; D011795:Surveys and Questionnaires; D014505:Urban Population