title: The Relationship of Adverse Childhood Events to Smoking, Overweight, Obesity and Binge Drinking Among Women in Hawaii.
abstract: To evaluate how the associations of adverse childhood events (ACEs) with smoking, overweight, obesity and binge drinking differ by race/ethnicity among women, including a large, understudied cohort of Asians and Native Hawaiians/Pacific Islanders (NHOPIs).
  
  
  
  The number and type (household dysfunction, and physical, verbal and sexual abuse) of ACEs were examined in relation to adulthood smoking, overweight, obesity and binge drinking among 3354 women in Hawaii using the 2010 Behavioral Risk Factor Surveillance System data using Poisson regression with robust error variance. We additionally investigated for interaction by race/ethnicity. Covariates included age, race/ethnicity, education, emotional support, healthcare coverage, and the other health outcomes.
  
  
  
  Overall, 54.9 % reported at least 1 ACE. The prevalence of smoking (PR = 1.40 (1 ACE) to PR = 2.55 [5+ ACEs]), overweight (PR = 1.22 [1 ACE] to PR = 1.31 [5+ ACEs]) and obesity (PR = 1.00 [1 ACE] to PR = 1.85 [5+ ACEs]) increased with increasing ACE count. Smoking was associated with household dysfunction (PR = 1.67, CI = 1.26-2.22), and physical (PR = 2.04, CI = 1.50-2.78) and verbal (PR = 1.62, CI = 1.25-2.10) abuse. Obesity was also significantly related to household dysfunction (PR = 1.22, CI = 1.01-1.48), and physical (PR = 1.36, CI = 1.10-1.70), verbal (PR = 1.35, CI = 1.11-1.64) and sexual (PR = 1.53, CI = 1.25-1.88) abuse. Among Asians, sexual abuse was associated with a lower prevalence of binge drinking (PR = 0.26, CI = 0.07-0.93), which was significantly different from the null association among Whites (interaction p = 0.02).
  
  
  
  Preventing/addressing ACEs may help optimize childhood health, and reduce the likelihood of smoking/obesity among women including Asians/NHOPIs. Further studies are warranted to evaluate the sexual abuse-binge drinking association among Asians, which may support the need for culturally-tailored programs to address ACEs.
authors.affiliation: 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.
authors.forename: Rosemay A
authors.initials: RA
authors.lastname: Remigio-Baker
authors.affiliation: Hawaii Department of Health, 1250 Punchbowl St, Honolulu, HI, 96813, USA.|Centers for Disease Control and Prevention, Atlanta, GA, 30341, USA.
authors.forename: Donald K
authors.initials: DK
authors.lastname: Hayes
authors.affiliation: Hawaii Department of Health, 1250 Punchbowl St, Honolulu, HI, 96813, USA.
authors.forename: Florentina
authors.initials: F
authors.lastname: Reyes-Salvail
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology / Q000523:psychology*; D040343:Behavioral Risk Factor Surveillance System; D015992:Body Mass Index; D001835:Body Weight; D016009:Chi-Square Distribution; D004522:Educational Status; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D008016:Life Change Events; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000523:psychology; D050177:Overweight / Q000453:epidemiology / Q000523:psychology; D016012:Poisson Distribution; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Adverse childhood events; Asians, Native Hawaiians and Pacific Islanders; Binge drinking; Obesity; Smoking; Women’s health