Donald K Warne
North Dakota State University, USA
Title: Disparities in adverse childhood experiences among American Indians
Biography
Biography: Donald K Warne
Abstract
The American Indian (AI) population in the United States suffers from significant health inequities. Death rates from diabetes, cancer, infant mortality, suicide and other causes are higher among AIs. Numerous psychosocial influences have led to unresolved trauma and associated poor health outcomes. The landmark Adverse Childhood Experiences (ACE) Study exposed a strong dose-response relationship between the breadth of exposure to childhood abuse or household dysfunction and the risk factors for several leading causes of death in adults. ACEs have since been linked to numerous detrimental health behaviors and poor health outcomes across the lifespan including smoking, alcohol abuse, drug abuse, depression, suicide, and general health-related quality of life. Additional research indicates that some vulnerable populations are more likely to have been exposed to childhood trauma, and populations that lack routine access to health care may face greater impacts from childhood trauma. The South Dakota Health Survey (SDHS) was a statewide health needs assessment survey of over 16,000 households in SD conducted from November 2013 – October 2014 and included over-sampling of AI and rural populations. Measures included screening for behavioral health disorders, ACEs, health service use, self-reported prevalence of several chronic diseases, and barriers to accessing care. We tested for differences among urban, rural, isolated, and AI reservation geographic areas after controlling for age and gender. Results showed significant disparities in ACEs among AIs and significant associations between higher ACE scores and health disparities.
