{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:32:33Z","timestamp":1777375953002,"version":"3.51.4"},"reference-count":48,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2024,10,16]],"date-time":"2024-10-16T00:00:00Z","timestamp":1729036800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Health Promot"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study examined whether the relationship between adverse childhood experiences (ACEs) and self-rated health among adults in a nationally representative population is modified by age, sex, or race\/ethnicity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>United States.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Sample<\/jats:title>\n                    <jats:p>Data from the 2020 and 2021 Behavioral Risk Factor Surveillance System were obtained from 185\u00a0731 (weighted N = 47\u00a0862\u00a0016) persons 18\u00a0years or older.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measures<\/jats:title>\n                    <jats:p>The ACE cumulative score (range: 0-11) was calculated using 11 questions about childhood emotional abuse, physical abuse, sexual abuse, and household dysfunction before age 18 and classified as 0 (reference), 1, 2, 3, or \u22654. Self-rated health was divided into (excellent\/very good\/good [reference]) and suboptimal (fair\/poor) categories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Analysis<\/jats:title>\n                    <jats:p>Multivariable-adjusted logistic regression was conducted to test for the interaction with age, sex, and race\/ethnicity with ACEs. After adjustment for potential confounders, an increasing number of ACEs had statistically significantly higher odds of suboptimal self-rated health in a graded manner except for 1 ACE (1 ACE: aOR:1.09; 95% CI: 1.00-1.20, 2 ACEs: 1.16; 1.03-1.30, 3 ACEs: 1.17; 1.03-1.32 and \u22654 ACEs: 1.39; 1.26-1.53). There was a significant interaction between ACEs and age. Younger age (18-24\u00a0years) had the strongest association for \u22654 ACEs compared to the older age groups. There was no effect modification by sex or race.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ACEs should be considered when creating health-promoting interventions to improve health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08901171241293412","type":"journal-article","created":{"date-parts":[[2024,10,16]],"date-time":"2024-10-16T21:12:53Z","timestamp":1729113173000},"page":"244-252","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Adverse Childhood Experiences and Suboptimal Self-Rated Health in Adulthood: Exploring Effect Modification by Age, Sex and Race\/Ethnicity"],"prefix":"10.1177","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8902-4356","authenticated-orcid":false,"given":"Olatokunbo","family":"Osibogun","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,10,16]]},"reference":[{"key":"bibr1-08901171241293412","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6844e1"},{"key":"bibr2-08901171241293412","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2009.09.020"},{"issue":"3","key":"bibr3-08901171241293412","first-page":"A52","volume":"7","author":"Dube SR","year":"2010","journal-title":"Prev Chronic Dis"},{"key":"bibr4-08901171241293412","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-3797(98)00017-8"},{"key":"bibr5-08901171241293412","doi-asserted-by":"publisher","DOI":"10.1016\/s0749-3797(98)00017-8"},{"key":"bibr6-08901171241293412","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-012-0554-1"},{"key":"bibr7-08901171241293412","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph20042829"},{"key":"bibr8-08901171241293412","doi-asserted-by":"publisher","DOI":"10.1016\/j.whi.2022.03.002"},{"key":"bibr9-08901171241293412","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwk113"},{"key":"bibr10-08901171241293412","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(17)30118-4"},{"key":"bibr11-08901171241293412","doi-asserted-by":"publisher","DOI":"10.1080\/2331205X.2019.1581447"},{"key":"bibr12-08901171241293412","doi-asserted-by":"publisher","DOI":"10.1002\/da.20238"},{"key":"bibr13-08901171241293412","doi-asserted-by":"publisher","DOI":"10.1093\/pubmed\/fdt038"},{"key":"bibr14-08901171241293412","doi-asserted-by":"publisher","DOI":"10.1542\/peds.111.3.564"},{"key":"bibr15-08901171241293412","doi-asserted-by":"publisher","DOI":"10.1007\/s10964-009-9490-0"},{"key":"bibr16-08901171241293412","doi-asserted-by":"publisher","DOI":"10.2307\/2673783"},{"key":"bibr17-08901171241293412","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2011.06.015"},{"key":"bibr18-08901171241293412","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2013.08.007"},{"key":"bibr19-08901171241293412","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2003.12.013"},{"key":"bibr20-08901171241293412","doi-asserted-by":"publisher","DOI":"10.1038\/s41390-020-01188-6"},{"key":"bibr21-08901171241293412","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1497.2005.00291.x"},{"key":"bibr22-08901171241293412","volume-title":"Health, United States, 2020-2021: Annual Perspective [Internet]","author":"National Center for Health Statistics (US)","year":"2023"},{"key":"bibr23-08901171241293412","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2008.10.017"},{"key":"bibr24-08901171241293412","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2010.06.007"},{"key":"bibr25-08901171241293412","volume-title":"Behavioral Risk Factor Surveillance System 2020 Summary Data Quality Report","author":"Centers for Disease Control and Prevention. 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