Citation

Kabani F, Lykens K, Tak HJ. J. Public Health Dent. 2018; 78(4): 313-320.

Affiliation

Department of Health Services Research & Administration, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.

Copyright

(Copyright © 2018, American Association of Public Health Dentists, Publisher John Wiley and Sons)

DOI

10.1111/jphd.12274

PMID

29752809

Abstract

OBJECTIVES: Evidence indicates that adverse childhood experiences (ACEs) have destructive impacts on quality of life, health outcomes, and health-care expenditures. Studies further demonstrate a dose-response relationship between the number of ACEs and risk for experiencing chronic illness, such as oral diseases later in life. Research is scarce on the prioritization of contextualized public health interventions addressing this important threat.

METHODS: Cross-sectional data from 2011 to 2012 National Survey of Children's Health (NSCH) provided a nationally representative sample of children in the United States, ages 1-17 for dentate status (n = 61,530). The dependent variables identified untreated oral health-care needs and preventive dental utilization. The key independent variables included exposure to parental death, parental divorce, parental incarceration, mental health illnesses, domestic violence, neighborhood violence, and racial discrimination. Exogenous variables included age, sex, race/ethnicity, number of children in household, socioeconomic status proxies, health insurance status, and special health needs. The data, when adjusted for complex survey design, proportionately represent children in the United States.

RESULTS: Unadjusted and adjusted logistic regressions revealed varying magnitudes of significance across diverse racial and ethnic profiles. Exposures to parental divorce and parental death particularly exhibited critical magnitudes of influence, compared to all other ACEs.

CONCLUSIONS: In keeping with the Pareto Principle, exposure to certain ACEs, namely parental divorce and parental death, potentially introduces more profound social and health-related consequences later in life. Therefore, contextualized interventions should prioritize public health efforts to address households burdened with exposure to parental divorce and/or parental death.

© 2018 American Association of Public Health Dentistry.

Language: en

Keywords

adult survivors of child adverse events; child; dental health surveys; oral health; quality of life