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Adverse childhood events lead to high out-of-pocket medical costs in adulthood
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Greater exposure to adverse childhood experiences was associated with higher out-of-pocket medical expenses and financial burden in adulthood, according to research published in the American Journal of Preventive Medicine.
"We have known for decades that childhood maltreatment is awfully common and increases one's risk of chronic diseases like heart disease, diabetes and mental illness lifelong,” Adam B. Schickedanz, MD, PhD, a pediatrician at UCLA Mattel Children’s Hospital, told Infectious Diseases in Children. “Our study quantified how those health risks impact people's pocketbooks. We found that adults who lived through adversity and trauma as children continue to pay a disproportionate economic price related to these worse health outcomes throughout adulthood.”
Schickedanz and colleagues analyzed data from the 2011 and 2013 Panel Study of Income Dynamics (PSID), a national phone survey of people’s household economic well-being, and the 2014-2015 PSID Childhood Retrospective Circumstances Study supplement, a web-based or mailed survey of adverse childhood experiences (ACEs). The researchers used statistical analysis to link associations between ACEs and household out-of-pocket (OOP) medical costs, controlling for factors including income and family type and size.
The study included 4,784 households (6,775 adults) with complete data.
The researchers found that compared with households reporting no ACEs (baseline annual OOP costs of $1,042), households reporting one or two ACEs had a 1.18-fold higher total annual OOP medical costs of $184 (95% CI, $90-$278), and those who reported three or more ACEs had a 1.3-fold higher annual total OOP costs of $311 (95% CI, $196-$426).
Schickedanz and colleagues also wrote that when an adult reported three or more ACEs, the odds were more than twice as high that annual household medical costs would exceed more than 10% of household income or 100% of household liquid assets compared with adults who reported no ACEs.
“For clinicians working with children and families, the findings suggest that we have an important role to play to intervene and prevent childhood adversity and its health and economic consequences,” Schickedanz said. “Our findings also suggest that we have a responsibility to treat the health consequences of ACEs in a trauma-informed manner that supports our patients' physical, mental and financial health." – by Bruce Thiel
Disclosures: The authors report no relevant financial disclosures.
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