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The Role of Socioeconomic Interventions in Reducing Exposure to Adverse Childhood Experiences: a Systematic Review

  • Social Epidemiology (J Dowd, Section Editor)
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Abstract

Purpose of Review

Adverse childhood experiences (ACE) are associated with key risk factors for adult morbidity and mortality. Most interventions to date target proximal risk factors and do not account for the structural determinants shaping the risk of childhood adversity. This review summarizes recent findings regarding the impact of socioeconomic interventions on ACE.

Recent Findings

Thirty-five percent of reviewed socioeconomic interventions reported reductions in exposure to ACE. Effect sizes were modest for family financial problems, adverse parenting, household mental illness, child maltreatment and neglect; moderate to high for exposure to domestic violence, Home score, parental separation, childhood physical abuse and household criminality; and strongest for childhood victimization and substance abuse. Housing, conditional cash transfer and income supplementation interventions were the most promising interventions.

Summary

Current evidence suggests that upstream interventions can contribute to the reduction of ACE. Future research should expand this work beyond developed countries using robust evaluation designs.

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Funding

This study was funded by the European Union’s Horizon 2020 Research and Innovation Programme (grant agreement no. 633666).

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Authors and Affiliations

  1. Harvard Center for Population and Development Studies, Harvard University, 9, Bow Street, Cambridge, MA, 02138, USA

    Emilie Courtin

  2. Department of Global Health and Social Medicine, King’s College London, London, UK

    Emily Allchin

  3. Imperial College Business School, Imperial College London, London, UK

    Annie J. Ding

  4. Department of Sociology, Trinity College Dublin, Dublin, Ireland

    Richard Layte

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  1. Emilie Courtin
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Correspondence to Emilie Courtin.

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Conflict of Interest

Emilie Courtin, Emily Allchin, and Richard Layte each declare no potential conflicts of interest.

Annie J. Ding reports European Union’s Horizon 2020 Research and Innovation Programme (grant agreement no. 633666).

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Appendix

Appendix

Fig. 2
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PRISMA flow diagram

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Fig. 3
figure 3

Risk of bias assessment by domains

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Fig. 4
figure 4

Risk of bias scores for quasi-experimental studies

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Fig. 5
figure 5

Risk of bias scores for experimental studies (cluster randomized controlled trials)

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Fig. 6
figure 6

Risk of bias scores for experimental studies (individual randomized controlled trials)

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Table 3 Overview of adverse childhood experiences measured by category of intervention
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Table 4 Estimates and effect sizes by category of intervention
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Courtin, E., Allchin, E., Ding, A.J. et al. The Role of Socioeconomic Interventions in Reducing Exposure to Adverse Childhood Experiences: a Systematic Review. Curr Epidemiol Rep 6, 423–441 (2019). https://doi.org/10.1007/s40471-019-00216-2

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