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  • 标题:Intergenerational Continuity in Adverse Childhood Experiences and Rural Community Environments
  • 本地全文:下载
  • 作者:Thomas J. Schofield ; M. Brent Donnellan ; Melissa T. Merrick
  • 期刊名称:American journal of public health
  • 印刷版ISSN:0090-0036
  • 出版年度:2018
  • 卷号:108
  • 期号:9
  • 页码:1148-1152
  • DOI:10.2105/AJPH.2018.304598
  • 语种:English
  • 出版社:American Public Health Association
  • 摘要:Objectives. To understand the role of the community environment on intergenerational continuity in adverse childhood experiences (ACEs) among a rural White sample. Methods. Parents in 12 counties in rural Iowa reported retrospectively on their own ACEs in 1989. We measured their child’s ACEs retrospectively and prospectively across adolescence (n = 451 families). We measured structural and social process–related measures of community environment (i.e., community socioeconomic status, parents’ perception of community services, perceived community social cohesion, and neighborhood alcohol vendor density) on multiple occasions during the child’s adolescence. Results. The 4 measures of community environment were all correlated with the child’s ACEs, but only alcohol vendor density predicted ACEs after inclusion of covariates. Intergenerational continuity in ACEs was moderated by both social cohesion (b = −0.11; SE = 0.04) and alcohol vendor density (b = −0.11; SE = 0.05). Conclusions. Efforts to increase community social cohesion and manage alcohol vendor density may assist families in breaking the cycle of maltreatment across generations. Childhood adversity, such as abuse, neglect, and environmental instability (collectively called adverse childhood experiences, or ACEs) has been associated with poorer physical health, 1 poorer mental health, 2 risky health behaviors, 1 and decreased life potential. 3 Abuse, neglect, and other adversities in childhood show intergenerational continuity (or similarity across parents and offspring) 4 ; and their impact on health and well-being can reverberate across generations. Therefore, reducing or preventing ACEs could produce long-lasting benefits in both health and life potential across generations. This makes the prevention of ACEs of significant interest to the public health community. Family functioning (i.e., maintaining a safe, stable, nurturing home environment) could be negatively affected by community risks, including low community socioeconomic status (SES), 5 lack of neighborhood services, 6 low social control or collective efficacy, 7 and high density of alcohol vendors. 8 Neighborhood conditions have been linked to multiple ACEs. 9–12 Understanding the effects of community-level attributes on ACEs can highlight areas in which community-level prevention efforts may be most effective at reducing exposure to ACEs. Community effects on ACEs are rarely studied among rural samples, yet almost 1 of 5 children in the United States live in rural areas, 13 and rural areas have fewer child abuse resources. 14 We hypothesized that a supportive community environment would be associated with fewer ACEs among a rural sample. If community environment predicts ACE score among the second generation (G2) after accounting for the ACE score of their parents (G1), it would further support the hypothesized protective role of the community context in reducing ACEs. Factors that increase or decrease intergenerational continuity in ACEs are unknown. A supportive community environment may change the magnitude of intergenerational continuity in ACEs. Such moderating effects of community characteristics have not been previously tested on intergenerational continuity in family functioning, nor on ACEs. However, community characteristics buffer the association between family risks (e.g., harsh parenting, maternal depression) and child behavior. 15 We included measures of the community environment previously linked with family functioning: SES, 5 neighborhood services, 6 social cohesion, 7 and alcohol vendor density. 8 We hypothesized that these community characteristics would change the amount of (i.e., moderate) intergenerational continuity in ACEs.
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