STRESS PATHWAYS TO HEALTH INEQUALITIES: EMBEDDING ACES WITHIN SOCIAL AND BEHAVIORAL CONTEXTS

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STRESS PATHWAYS TO HEALTH INEQUALITIES: EMBEDDING ACES WITHIN SOCIAL AND BEHAVIORAL CONTEXTS

`   TABLE OF CONTENTS

Cover page

Title page

Certification        –       –       –       –       –       –       –       –       i

Dedication –       –       –       –       –       –       –       –       –       ii

Acknowledgement      –       –       –       –       –       –       –       iii

Abstract     –       –       –       –       –       –       –       –       –       v

Table of contents        –       –       –       –       –       –       –       –       vi

CHAPTER ONE: INTRODUCTION

1.1    Background of the Study     –       –       –       –       –       1

1.2    Statement of Problem  –       –       –       –       –       –       7

1.3    Purpose of the study           –       –       –       –       –       8

1.4    Objective of the Study –       –       –       –       –       –       9

1.4    Research Questions    –       –       –       –       –       –       10

1.5    Research Hypothesis   –       –       –       –       –       –       10

1.6    Significance of the Study     –       –       –       –       –       11

1.7    Scope of the study      –       –       –       –       –       –       11

1.8    Limitation of the study         –       –       –       –       –

1.9    Definition of Terms             –       –       –       –       –       12

CHAPTER TWO: REVIEW OF RELATED LITERATURE

2.1    Introduction       –       –       –       –       –       –       –       14

2.2 The Theoretical frame Work –       –       –       –       –       21

2.3 conceptual frame work

2.4 empirical review

CHAPTER THREE: RESEARCH METHODOLOGY

3.1    Introduction       –       –       –       –       –       –       –       82

3.2    Area of the study                –       –       –       –       –       –       82

3.3    Research Design        –       –       –       –       –       –       82

3.4    Sample and sampling techniques –       –       –       –       83

3.5    Population of the study               –       –       –       –       –       84

3.6    Procedure for Data Collection      –       –       –       –       85

3.7    Method of Data Analysis      –       –       –       –       –       85

CHAPTER FOUR: PRESENTATION, ANALYSIS AND INTERPRETATION OF DATA

4.1    Introduction       –       –       –       –       –       –       –       87

4.2    Presentation of Data           –       –       –       –       –       87

4.3    Data Analysis     –       –       –       –       –       –       –       88

4.4    Testing of Hypothesis          –       –       –       –       –       91

4.5    Discussion and summary of findings             –       –       94

CHAPTER FIVE:

INTRODUCTION, SUMMARY, RECOMMENDATIONS AND CONCLUSION

5.0    Introduction       –       –       –       –       –       –       –       98

5.1    Summary           –       –       –       –       –       –       –       99

5.2    Conclusion –       –       –       –       –       –       –       –       100

5.3    Recommendations      –       –       –       –       –       –       101

REFERENCES

Appendix

Questionnaire

Abstract

Objective: This study addresses whether adverse childhood experiences (ACEs) demonstrate disproportional prevalence across demographic- and health-affecting characteristics, offer significant explanation of adult health outcomes, and show patterned association with illness susceptibility early within and across adulthood when viewed in combination with income and psychosocial resources.

Methods: Data were derived from a population-based state health survey using stratified random sampling of household adults (n=7,470): ages 18-99 (M=55), 59.9% females, and race/ethnicity, income and education levels representative of the region. We assessed ACEs by aggregating 8 adversity forms, 5 health behaviors and 3 psychosocial resources; and health outcomes (number of chronic conditions, subjective wellness).

Results: Disproportionality was evident in ACEs levels by demographics, adult SES, health behaviors, and psychosocial resources in expected directions. Stepped multiple regressions of health outcomes demonstrated significant betas and R2 change for each predictor block, revealing cumulative as well as unique explanatory utility. Early onset chronic illness was evident on the basis of ACEs levels. These illnesses were amplified for low income respondents. Prevalence was highest across adulthood for those also reporting low psychosocial assets.

Conclusions: Findings offer novel insights as to the “long reach” of childhood adversity on health, conditioned by circumstances under which these effects may occur. Health resilience offered by health behaviors and psychosocial resources should shape thinking about preventive and remedial interventions by social work and allied professionals across a range of settings.

STRESS PATHWAYS TO HEALTH INEQUALITIES: EMBEDDING ACES WITHIN SOCIAL AND BEHAVIORAL CONTEXTS

 

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