Impact of Adverse Childhood Experiences in a Student-Run Free Clinic Population

Abstract

Background: Adverse childhood experiences (ACEs) correlate with development of chronic disease and early death. High ACEs are more common in underserved populations. The objective is examining how ACE scores correlate to the presence and severity of chronic diseases in student-run free clinic (SRFC) populations.
Methods: This study took place at the University of Arkansas for Medical Sciences (UAMS) 12th Street Health and Wellness Center, an SRFC in Little Rock, Arkansas. Included were patients diagnosed with at least one of the following: hypertension, diabetes, depression, chronic headaches, and chronic obstructive pulmonary disease. Surveys were administered to determine the amount and type of ACEs, and scores were calculated. Relative risks for effects of ACE exposure were assessed on chronic disease. Univariate and multivariate analyses for ACE and chronic disease association was conducted.
Results: A total of 75 patients completed the survey. Prevalence of ACEs >1 among UAMS patients was 61 (81.3) and more common in women and non-smokers. Exposure to physical abuse showed 55% higher risk of more than one chronic disease than without exposure. Patients reporting 3-4 or >5 ACEs had 2.00 or 1.69 times the risk of having more than one chronic disease compared to no ACEs in an adjusted analysis, respectively.
Conclusions: ACEs were more prevalent in this SRFC than the general public. Exposure to more ACEs was associated with an increased risk for having one or more chronic disease. The study provides novel evidence of the increased risk this SRFC population has for ACEs and identifies a possible need for additional resources.