Affordable Access

deepdyve-link
Publisher Website

Rural-Urban Differences in Adverse Childhood Experiences Across a National Sample of Children.

Authors
  • Crouch, Elizabeth1
  • Radcliff, Elizabeth1
  • Probst, Janice C1
  • Bennett, Kevin J2
  • McKinney, Selina Hunt3
  • 1 South Carolina Rural Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.
  • 2 School of Medicine, University of South Carolina, Columbia, South Carolina.
  • 3 College of Nursing, University of South Carolina, Columbia, South Carolina.
Type
Published Article
Journal
The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association
Publication Date
Jan 01, 2020
Volume
36
Issue
1
Pages
55–64
Identifiers
DOI: 10.1111/jrh.12366
PMID: 30938864
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The purpose of this study was to examine the prevalence of adverse childhood experiences (ACEs) exposure in 34 states and the District of Columbia, and whether exposure differs between rural and urban residents. This cross-sectional study used data from the 2016 National Survey of Children's Health (NSCH), restricted to states in which rural versus urban residence was indicated in the public use data (n = 25,977 respondents). Bivariate analyses were used to estimate unadjusted associations. Multivariable regression models were run to examine the association between residence (rural or urban) and ACE counts of 4 or more. Compared to urban children, rural children had higher rates of exposure to the majority of the ACEs examined: parental separation/divorce, parental death, household incarceration, household violence, household mental illness, household substance abuse, and economic hardship. In adjusted analysis, there was no significant difference for rural children compared to urban children. The odds of 4 or more ACEs decrease as poverty levels decline, with children residing 0%-99% below the federal poverty line more likely to have reported 4 or more ACEs, compared to children residing 400% or above the federal poverty line (aOR 4.02; CI: 2.65-6.11). Our findings suggest that poverty is a key policy lever that may mitigate the burden of ACE exposure. The findings of this study may be instructive for policymakers and program planners as they develop interventions to stop, reduce, or mitigate ACE exposure and the long-term impact of ACEs among children in rural America. © 2019 National Rural Health Association.

Report this publication

Statistics

Seen <100 times