Adverse Childhood Events are Related to the Prevalence of Asthma and Chronic Obstructive Pulmonary Disorder Among Adult Women in Hawaii.
OBJECTIVE
In the US, women surpass men in the prevalence of lung diseases. Limited studies exist on the association of adverse childhood events (ACEs) to asthma and chronic obstructive pulmonary disorder (COPD) particularly among women and cohorts of understudied populations (e.g., Pacific Islanders). This study evaluated the ACEs-asthma and ACEs-COPD relationships among women in Hawaii and the contribution of poor health factors (smoking, binge drinking, and obesity) in these associations.


METHODS
Using data from 3363 women in the Behavioral Risk Factor Surveillance System-Hawaii, we assessed how self-reported ACEs [count and type (household dysfunction, and physical, verbal and sexual abuse)] relate to asthma and COPD. Multivariable log-binomial regression, accounting for the sampling design, and model adjustments for socio-demographics, healthcare access, emotional support, current smoking, binge drinking, and BMI status were used to generate prevalence ratios.


RESULTS
For every increase in ACE count, the likelihood for asthma increased by 7 % (CI = 1.02-1.13), and for COPD, by 21 % (CI = 1.12-1.31) accounting for socio-demographics, healthcare access, and emotional support. Verbal abuse was also associated with greater likelihood for asthma independent of these covariates (PR = 1.43, CI = 1.14-1.79). Household dysfunction (PR = 1.82, CI = 1.15-2.82) and physical (PR = 2.01, CI = 1.20-3.37), verbal (PR = 2.24, CI = 1.38-3.65) and sexual (PR = 1.81, CI = 1.10-2.97) abuse were all associated with COPD using similar adjustments. Additional adjustment for smoking, binge drinking, and BMI status did not impact the ACE-asthma associations and only modestly attenuated the ACE-COPD relationships.


CONCLUSIONS
Primary and secondary prevention of ACEs may optimize the health of young girls in Hawaii, and reduce the burden of asthma and COPD among women in the state.
Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive, MC 0725, La Jolla, CA, 92093-0725, USA. rremigiobaker@gmail.com.
Rosemay A
RA
Remigio-Baker
Family Health Services Division, Hawaii Department of Health, 3652 Kilauea Ave., Honolulu, HI, 96816, USA.
Donald K
DK
Hayes
Family Health Services Division, Hawaii Department of Health, 3652 Kilauea Ave., Honolulu, HI, 96816, USA.
Florentina
F
Reyes-Salvail
D000069586:Adult Survivors of Child Adverse Events / Q000706:statistics & numerical data*; D000367:Age Factors; D001249:Asthma / Q000453:epidemiology*; D040343:Behavioral Risk Factor Surveillance System; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology*; D012044:Regression Analysis; D012907:Smoking / Q000453:epidemiology*
Adverse childhood events; Asthma; BRFSS; COPD; Hawaii; Women’s health