title: Effect of adverse childhood experiences on physical health in adulthood: Results of a study conducted in Baghdad city.
abstract: BACKGROUND
  Studies have revealed a powerful relationship between adverse childhood experiences (ACEs) and physical and mental health in adulthood. Literature documents the conversion of traumatic emotional experiences in childhood into organic disease later in life.
  
  
  OBJECTIVE
  The aim was to estimate the effect of childhood experiences on the physical health of adults in Baghdad city.
  
  
  METHODS
  A cross-sectional study was conducted from January 2013 to January 2014. The study sample was drawn from Baghdad city. Multistage sampling techniques were used in choosing 13 primary health care centers and eight colleges of three universities in Baghdad. In addition, teachers of seven primary schools and two secondary schools were chosen by a convenient method. Childhood experiences were measured by applying a modified standardized ACEs-International Questionnaire form and with questions for bonding to family and parental monitoring. Physical health assessment was measured by a modified questionnaire derived from Health Appraisal Questionnaire of Centers for Disease Control and Prevention. The questionnaire includes questions on cerebrovascular diseases, diabetes mellitus, tumor, respiratory and gastrointestinal diseases.
  
  
  RESULTS
  Logistic regression model showed that a higher level of bonding to family (fourth quartile) is expected to reduce the risk of chronic physical diseases by almost the half (odds ratio = 0.57) and exposure to a high level of household dysfunction and abuse (fourth quartile) is expected to increase the risk of chronic physical diseases by 81%.
  
  
  CONCLUSIONS
  Childhood experiences play a major role in the determination of health outcomes in adulthood, and early prevention of ACEs. Encouraging strong family bonding can promote physical health in later life.
authors.affiliation: Department of Community Medicine, College of Medicine, Al Mustansiriya University, Baghdad, Iraq.
authors.forename: Ameel F
authors.initials: AF
authors.lastname: Al-Shawi
authors.affiliation: Department of Community Medicine, College of Medicine, Al Mustansiriya University, Baghdad, Iraq ; Public Health Department, University of Washington, Seattle, Washington, USA.
authors.forename: Riyadh K
authors.initials: RK
authors.lastname: Lafta
keywords: Adverse childhood experiences; Baghdad; family bonding; physical health; violence