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Homelessness in Childhood and Adverse Childhood Experiences (ACEs)

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Abstract

Objectives Research on adverse childhood experiences (ACEs) has provided a valuable framework for understanding associations between childhood maltreatment and family dysfunction and later poor health outcomes. However, increasing research suggests the number and types of childhood adversities measured warrants further examination. This study examines ACE exposure among adults who experienced homelessness in childhood, another type of childhood adversity. Methods This cross-sectional, descriptive study used the 2016 South Carolina (SC) Behavioral Risk Factor Surveillance System (BRFSS) survey and additional ACE modules to examine ACE exposure among SC adults and childhood homelessness. Standard descriptive statistics were calculated for each variable. Bivariate analysis compared types and number of ACEs by childhood homeless status. All analyses used survey sampling weights that accounted for the BRFSS sampling strategy. Results Data from 7490 respondents were weighted for analyses. Among the 215 respondents who reported homelessness in childhood, 68.1% reported experiencing four or more ACEs. In contrast, only 16.3% of respondents who reported no homelessness in childhood reported experiencing four or more ACEs. The percent of respondents was significantly higher for each of 11 ACEs among those who reported childhood homelessness, compared to those who did not. Conclusions for Practice Adults who reported homelessness in childhood also reported significantly greater exposure to higher numbers and types of ACEs than adults reporting no childhood homelessness. Study findings can be important in informing additional indicators important to the assessment of ACEs and to program developers or organizations that provide housing assistance to at-risk families and children.

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Acknowledgements

The authors thank Chelsea Richard, MSPH of the Division of Surveillance, Bureau of Health Improvement and Equity for her help and expertise with data acquisition.

Disclosure

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of Children’s Trust of South Carolina, South Carolina Department of Health and Environmental Control, or the BlueCross BlueShield of South Carolina Foundation. The authors have no financial relationships relevant to this article to disclose.

Funding

This project was supported in part by Children’s Trust of South Carolina; South Carolina Department of Health and Environmental Control; and the BlueCross BlueShield of South Carolina Foundation.

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Authors and Affiliations

  1. Department of Health Services Policy and Management, Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, 220 Stonebridge Drive, Suite 204, Columbia, SC, 29210, USA

    Elizabeth Radcliff & Elizabeth Crouch

  2. Children’s Trust of South Carolina, Columbia, SC, USA

    Melissa Strompolis & Aditi Srivastav

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  1. Elizabeth Radcliff
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  2. Elizabeth Crouch
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Correspondence to Elizabeth Radcliff.

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Radcliff, E., Crouch, E., Strompolis, M. et al. Homelessness in Childhood and Adverse Childhood Experiences (ACEs). Matern Child Health J 23, 811–820 (2019). https://doi.org/10.1007/s10995-018-02698-w

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