Adverse Childhood Experiences (ACE) among American Indians in South Dakota and Associations with Mental Health Conditions, Alcohol Use, and Smoking

J Health Care Poor Underserved. 2017;28(4):1559-1577. doi: 10.1353/hpu.2017.0133.

Abstract

Objectives: To assess the prevalence of Adverse Childhood Experiences (ACEs) and their association with behavioral health in American Indian (AI) and non-AI populations in South Dakota.

Methods: We included the validated ACE questionnaire in a statewide health survey of 16,001 households. We examined the prevalence of ACEs and behavioral health conditions in AI and non-AI populations and associations between ACEs and behavioral health.

Results: Compared with non-AIs, AIs displayed higher prevalence of ACEs including abuse, neglect, and household dysfunction and had a higher total number of ACEs. For AIs and non-AIs, having six or more ACEs significantly increased the odds for depression, anxiety, PTSD, severe alcohol misuse, and smoking compared with individuals with no ACEs.

Conclusions: American Indians in South Dakota experience more ACEs, which may contribute to poor behavioral health. Preventing and mitigating the effects of ACEs may have a significant impact on health disparities in AI populations.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Alcohol Drinking / ethnology*
  • Female
  • Health Status Disparities
  • Health Surveys
  • Humans
  • Indians, North American / psychology*
  • Indians, North American / statistics & numerical data
  • Life Change Events*
  • Male
  • Mental Disorders / ethnology*
  • Middle Aged
  • Prevalence
  • Smoking / ethnology*
  • South Dakota / epidemiology
  • Young Adult