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Adverse Childhood Experiences and Diabetes in Adulthood: Support for a Collaborative Approach to Primary Care

Abstract

Prior studies have demonstrated an association between retrospective reports of experiencing trauma in childhood and the current incidence of type 2 diabetes in adulthood. Much less is known about this association among low-income minority patients in primary care settings. We replicated the adverse childhood experiences (ACEs) Centers for disease control and prevention (CDC) study with a low-income minority sample of primary care patients (N = 801) at a community-based healthcare center. We conducted a cross-sectional retrospective quantitative survey study to examine the association between participants’ reports of past childhood trauma and their current health care outcomes. Data were analyzed using binary logistic regression to evaluate the hypothesis that low income minority patients who reported more childhood trauma (abuse, neglect, household dysfunction, cumulative adverse childhood experiences [ACEs]) would more likely be diagnosed with type 2 diabetes. Results suggest that the number of ACEs in our sample were considerably higher than the original CDC ACEs study, as almost 50 % of patients surveyed at our clinic reported 4 or more ACEs, confirming that trauma is central in our urban primary care setting. The results of the cumulative ACEs score was in the expected direction and was significant, suggesting that participants who cumulatively reported experiencing more childhood trauma were more likely to be diagnosed with type 2 diabetes in adulthood. These findings have implications for family therapists, primary care providers, researchers, and policy makers to develop more collaborative approaches to primary care that better target the negative sequelae of ACEs.

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Acknowledgments

We thank all study participants for sharing their personal life histories. Supported by the BARRA Inc., Foundation, Philadelphia, Pennsylvania.

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Correspondence to Laura Lynch.

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Lynch, L., Waite, R. & Davey, M.P. Adverse Childhood Experiences and Diabetes in Adulthood: Support for a Collaborative Approach to Primary Care. Contemp Fam Ther 35, 639–655 (2013). https://doi.org/10.1007/s10591-013-9262-6

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Keywords

  • Childhood trauma
  • Diabetes
  • Ethnic minority
  • Collaborative care