in Albania - Instituti i Shendetit Publik

INTERNATIONAL PUBLIC HEALTH CONFERENCE IN TIRANA, ALBANIARelationship of childhood abuse and householddysfunction with the leading causes of death inadultsRovena Daja 1 , Gentiana Qirjako 1,21Institute of Public Health, Tirana, Albania;2Faculty of Public Health, University of Medicine, Tirana, Albania.The relationship of risky behaviors and diseases inadulthood to the breadth of exposure to childhoodemotional, physical, or sexual abuse, and householddysfunction during childhood has not beenpreviously described in Albania.The current evidence pertains mainly to industrializedsocieties, USA in particular. Although studies ofclinical samples in USA have identified links betweenchildhood abuse, especially sexual abuse, and adultrisky behaviors, the generalizability of these findingsto the overall population and the relative importanceof different types of abuse in men and women arenot known. A questionnaire about adversechildhood experiences was mailed to 13,494 adultsby the Department of Preventive Medicine,Southern California (1998), who had completed astandardized medical evaluation at a large HMO;overall, 9,508 (70.5%) individuals responded. Sevencategories of adverse childhood experiences werestudied: psychological, physical, or sexual abuse;violence against mother; or living with householdmembers who were substance abusers, mentally illor suicidal, or ever imprisoned. The number ofcategories of these adverse childhood experienceswas then compared to measures of adult riskbehavior, health status, and disease. Logisticregression was used to adjust for effects ofdemographic factors on the association between thecumulative number of categories of childhoodexposures (range: 0-7) and risk factors for theKeywords: abuse, adverse childhood experiences, violence.leading causes of death in adult life.More than half of respondents reported at leastone, and one-fourth reported e 2 categories ofchildhood exposures. This study reported a gradedrelationship between the number of categories ofchildhood exposure and each of the adult healthrisk behaviors and diseases that were studied(P