Abstract
Objectives
This study investigated associations between three types of child maltreatment (exposure to intimate partner violence, sexual, and physical abuse) and multimorbidity (chronic physical conditions, pain conditions, and mental disorders) in adults.
Methods
Multinomial logistic regression was used to analyze weighted data from the 2012 Canadian Community Health Survey (CCHS - MH 2012), a representative population sample (N = 23,846) of respondents ages 18+.
Results
All three subtypes of child maltreatment independently predicted increased odds of experiencing multimorbidity as an adult, while adjusting for covariates (adjusted odds ratios ranged from 1.34 (95% CI = 1.00, 1.80) to 4.87 (95% CI = 2.75, 8.63)). A dose-response relationship between the number of child maltreatment subtypes and risk for multimorbidity was also observed (adjusted odds ratios ranged from 1.38 (95% CI = 1.11, 1.73) to 10.96 (95% CI = 6.12, 19.64)).
Conclusion
The current results highlight the importance of considering a range of childhood adversities and suggest that public health approaches that aim to decrease the prevalence and severity of child maltreatment have the potential to ameliorate adult multimorbidities. Future research is encouraged to investigate these issues using longitudinal population-level data.
Résumé
Objectifs
Examiner les associations entre trois types de maltraitance des enfants (exposition à la violence envers la ou le partenaire intime, violence sexuelle et violence physique) et la multimorbidité (douleurs, troubles mentaux et troubles physiques chroniques) à l’âge adulte.
Méthode
Nous avons employé la régression logistique multinomiale pour analyser les données pondérées de l’Enquête sur la santé dans les collectivités canadiennes de 2012 (ESCC - Santé mentale 2012), une population-échantillon représentative (N = 23 846) de répondants de 18 ans et plus.
Résultats
Les trois sous-types de maltraitance des enfants ont prédit indépendamment des probabilités accrues de multimorbidité à l’âge adulte en tenant compte des covariables (les rapports de cotes ajustés allaient de 1,34 [IC de 95% = 1,00, 1,80] à 4,87 [IC de 95% = 2,75, 8,63]). Une relation dose-réponse a aussi été observée entre le nombre de sous-types de maltraitance des enfants et le risque de multimorbidité (les rapports de cotes ajustés allaient de 1,38 [IC de 95% = 1,11, 1,73] à 10,96 [IC de 95% = 6,12, 19,64]).
Conclusion
Ces résultats font ressortir l’importance de tenir compte d’une gamme d’épreuves pouvant être vécues par les enfants et indiquent que des démarches de santé publique qui visent à réduire la prévalence et la gravité de la maltraitance des enfants pourraient améliorer la multimorbidité chez les adultes. Nous encourageons l’étude de ces questions à l’aide de données populationnelles longitudinales.
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Acknowledgements
Statistics Canada collected and provided the data for academic purposes, but the analyses are the sole responsibility of the authors. The opinions expressed do not represent the views of Statistics Canada.
Funding
M. Ferro currently holds the Canada Research Chair in Youth Mental Health. H.L. MacMillan is supported by the Chedoke Health Chair in Child Psychiatry. A. Gonzalez is supported by a Canadian Institutes of Health Research New Investigator Award.
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England-Mason, G., Casey, R., Ferro, M. et al. Child maltreatment and adult multimorbidity: results from the Canadian Community Health Survey. Can J Public Health 109, 561–572 (2018). https://doi.org/10.17269/s41997-018-0069-y
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DOI: https://doi.org/10.17269/s41997-018-0069-y