Dissertations and Theses (Open Access)

Date of Award

Spring 4-2024

Degree Name

Master of Public Health (MPH)

Advisor(s)

Eric C Jones

Second Advisor

Catherine L. Troisi

Abstract

Introduction: Adverse childhood experiences are common in the United States with about 64% of the population affected. Adverse childhood experiences are predictors of many chronic diseases including mental illnesses like anxiety. Though non-Hispanic whites are mostly afflicted by anxiety compared to their racial counterparts, minority races like non- Hispanic Black/African Americans disproportionately suffer more dire consequences due to the chronicity of untreated conditions which often result from lack of access to care among other barriers. Methods: This is a retrospective cross-sectional study. BRFSS 2022 data set was used to identify 56,598 respondents, ages 18 to 44 years old for analysis. Descriptive, univariate and three multivariable logistic regression analyses were fitted. Model 1 adjusted for sociodemographic variables (age, sex, race, and marital status), model 2 adjusted for socioeconomic variables (health insurance status, income level, employment status, home ownership status, and education level), while model 3 adjusted for both sociodemographic and socioeconomic variables. Akaike information criterion (AIC) scores were obtained and used to identify the best model. Results: From the total study population, 46.86% of respondents make up the moderate/severe anxiety-related stress symptoms group. This study revealed a reasonably steady rise in the odds of having moderate/severe anxiety-related stress symptoms between an ACE score of 1 and 10 (Score 1 [adjusted Odds Ratio (aOR) = 0.73, 95% CI: 0.18 – 2.98]; Score 10 [aOR = 8.70, 95% CI: 3.46 – 21.85]) in comparison to an ACE score of 0 after adjusting for all covariates. Minority races like non-Hispanic Blacks (aOR = 0.71, 95% CI: 0.63 – 0.80) are apparently less associated with anxiety-related stress symptoms in comparison to non-Hispanic Whites. Model 3 had the lowest akaike information criterion score (AIC: 74,736.72) making it the best model. Conclusion: These analyses provided evidence that adverse childhood experiences is strongly associated with anxiety-related stress symptoms. Creating sustainable and affordable community-led interventions that help support families can be a very useful way of decreasing exposure to adverse childhood experiences and eventually, young adults affected by debilitating moderate to severe anxiety-related stress symptoms.

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