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How community resources mitigate the association between household poverty and the incidence of adverse childhood experiences.

Authors
  • Blair, Alexandra1, 2, 3
  • Marryat, Louise4, 5, 6
  • Frank, John7
  • 1 Département de médecine sociale et préventive, École de santé publique, Université de Montréal, Montreal, Canada. [email protected] , (Canada)
  • 2 Centre de recherche du Centre hospitalier de l'Université de Montréal, 850 Ave. St-Denis, #S03-710, Montreal, Quebec, Canada. [email protected] , (Canada)
  • 3 Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, Edinburgh, UK. [email protected]
  • 4 Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, Edinburgh, UK.
  • 5 The Farr Institute of Health Informatics Research, Edinburgh, UK.
  • 6 Salvesen Mindroom Research Centre, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
  • 7 Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.
Type
Published Article
Journal
International journal of public health
Publication Date
Sep 01, 2019
Volume
64
Issue
7
Pages
1059–1068
Identifiers
DOI: 10.1007/s00038-019-01258-5
PMID: 31139849
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To assess what proportion of the association between household low income and incidence of adverse childhood experiences (ACE) would be eliminated if all households had access to housing, transportation and childcare services, breastfeeding counselling, and parks. Using Growing Up in Scotland birth cohort data (N = 2816), an inverse probability-weighted regression-based mediation technique was applied to assess associations between low-income status (< £11,000 in 2004/5), resource access, and cumulative 8-year ACE incidence (≥ 1, ≥ 3 ACEs). Resource access was measured based on households' self-reported difficulties (yes/no) in accessing housing, transportation, childcare, and breastfeeding counselling, and park proximity (within 10 min from the residence). The protective effects of resources were heterogeneous. Only access to transportation was associated with lower ACE incidence in both low- and higher-income households. If all had access to transportation, 21% (95% CI 3%, 41%) of the income-based inequality in incidence of 3 or more ACEs could be eliminated. While second best to the elimination of child poverty, measures to improve families' access to community resources such as transportation may mitigate the effects of poverty on ACE incidence.

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