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Title [en]
Adverse childhood experiences, alcohol use in adulthood and mortality: Examining the associations using retrospective survey data and record linkage in Estonia
Abstract [en]
Longitudinal research suggests that childhood socioeconomic and psychosocial environment impact on health status in adulthood. Adverse childhood experiences (ACEs) have been linked to a wide range of physical and psychological health conditions in adulthood (including cardiac disease, cancer, lung disease and major depressive disorder) and to an increased risk of premature death. Despite the potential importance of the ACEs-adult health relation, as yet, the specific mechanism(s) linking ACEs with poorer adult health are unknown. Some studies have indicated that risky health behaviours may link ACEs and poor adult health, as adults who have experienced childhood adversities are at an increased risk of smoking, drinking and using illicit drugs. The aim of the present study is to use retrospective survey data and mortality registry data from Estonia, to examine if there is an association between ACEs and harmful alcohol consumption in adulthood, and whether risky drinking lies on the pathway between ACEs and premature adult mortality. The current study will build on and develop previous research in several ways. By extending this research to Eastern Europe it will be possible to focus on unique childhood adversities such as parental political repression and link it to adult mortality. By elucidating the relation between ACEs, health behaviour and subsequent mortality this research has potentially important theoretical and public health implications.
Publications (5 of 5) Show all publications
Stickley, A. & Leinsalu, M. (2018). Childhood hunger and depressive symptoms in adulthood: findings from a population-based study. Journal of Affective Disorders, 226, 332-338
Open this publication in new window or tab >>Childhood hunger and depressive symptoms in adulthood: findings from a population-based study
2018 (English)In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 226, p. 332-338Article in journal (Refereed) Published
Abstract [en]

Background: Several studies have linked childhood hunger to an increased risk for later depression. However, as yet, there has been little research on this relation in adults of all ages or whether there are sex differences in this association. The current study examined these issues using data from a national population-based sample.

Methods: Data were analyzed from 5095 adults aged 25–84 collected during the Estonian Health Interview Survey 2006. Information was obtained on the frequency of going to bed hungry in childhood and on depressive symptoms using the Emotional State Questionnaire (EST-Q). Logistic regression analysis was used to examine the association between hunger and depression while controlling for other demographic, socioeconomic and health-related variables.

Results: In a fully adjusted model, going to bed hungry in childhood either sometimes or often was associated with significantly increased odds for adult depressive symptoms. When the analysis was stratified by sex the association was more evident in men where any frequency of childhood hunger was linked to adult depression while only women who had experienced hunger often had higher odds for depressive symptoms in the final model.

Limitations: Data on childhood hunger were retrospectively reported and may have been affected by recall bias. We also lacked information on potentially relevant variables such as other childhood adversities that might have been important for the observed associations.

Conclusion: Childhood hunger is associated with an increased risk for depressive symptoms among adults. Preventing hunger in childhood may be important for mental health across the life course.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
adult, childhood, depression, hunger, stress
National Category
Sociology
Research subject
Baltic and East European studies
Identifiers
urn:nbn:se:sh:diva-33403 (URN)10.1016/j.jad.2017.09.013 (DOI)000414329000045 ()29031183 (PubMedID)2-s2.0-85030995992 (Scopus ID)
Funder
The Foundation for Baltic and East European Studies, 50/2014
Note

Also funded by Estonian Research Council (IUT5-1)

Available from: 2017-09-15 Created: 2017-09-15 Last updated: 2022-03-01Bibliographically approved
Stickley, A., Koyanagi, A., Inoue, Y. & Leinsalu, M. (2018). Childhood hunger and thoughts of death or suicide in older adults. The American journal of geriatric psychiatry, 26(10), 1070-1078
Open this publication in new window or tab >>Childhood hunger and thoughts of death or suicide in older adults
2018 (English)In: The American journal of geriatric psychiatry, ISSN 1064-7481, E-ISSN 1545-7214, Vol. 26, no 10, p. 1070-1078Article in journal (Refereed) Published
Abstract [en]

Objective There is little research on the effects of childhood hunger on adult mental health. This study examined the association between childhood hunger and recurrent thoughts of death or suicide in older adults. Design Data were analyzed from adults aged 60 and above collected during the Estonian Health Interview Survey 2006 (N=2455). Retrospective information was obtained on the frequency (never, seldom, sometimes, often) of going to bed hungry in childhood, and on the presence of recurrent thoughts of death or suicide in the past 4 weeks. Multivariate logistic regression analysis was used to examine associations between the variables. Results Experiencing hunger in childhood was common (37.6%) with 14.3% of the respondents stating that they often went to bed hungry. In a univariate analysis going to bed hungry either sometimes or often more than doubled the odds for thoughts of death or suicide. Although adjustment for a range of covariates (including physical diseases and depressive episode) attenuated the associations, in the fully adjusted model going to bed hungry sometimes continued to be associated with significantly increased odds for thoughts of death or suicide in older adults (OR = 1.74, 95% CI = 1.10–2.74; Wald χ2 = 5.7, df = 1, p = 0.017). Conclusion The findings of this study suggest that the effects of childhood hunger may be long lasting and associated with mental health and well-being even in older adults.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
childhood, hunger, death ideation, suicide ideation, Estonia
National Category
Sociology
Research subject
Baltic and East European studies
Identifiers
urn:nbn:se:sh:diva-35774 (URN)10.1016/j.jagp.2018.06.005 (DOI)000445766200010 ()30076079 (PubMedID)2-s2.0-85050695608 (Scopus ID)
Funder
The Foundation for Baltic and East European Studies, 50/2014
Available from: 2018-06-29 Created: 2018-06-29 Last updated: 2022-03-01Bibliographically approved
Reile, R. & Leinsalu, M. (2017). Ethnic variation in self-rated health–mortality association: Results from a 17-year follow-up study in Estonia. Medicina, 53(2), 114-121
Open this publication in new window or tab >>Ethnic variation in self-rated health–mortality association: Results from a 17-year follow-up study in Estonia
2017 (English)In: Medicina, ISSN 1010-660X, E-ISSN 1648-9144, Vol. 53, no 2, p. 114-121Article in journal (Refereed) Published
Abstract [en]

Previous research has highlighted the role of self-rated health (SRH) as an important predictor of mortality. With substantial ethnic differences in SRH and mortality reported in Estonia, this study aims to examine the ethnic variation in SRH–mortality association in this setting. Materials and methods The baseline data come from nationally representative 1996 Estonian Health Interview Survey. Individual records of 3983 respondents in the 25–79 age group were linked with mortality data with 17 years follow-up time. The association between SRH and all-cause mortality was analysed using the Cox regression for two ethnic groups and separately for men and women. Results Among ethnic Estonians, both men and women with bad or very bad SRH had about 60% higher mortality compared to those with good or very good SRH even after adjustment for age, socioeconomic and health-related variables. In contrast, SRH did not predict mortality among non-Estonian men and women. A strong and universal inverse association with mortality was found for personal income. Education (among men) and occupation (among women) predicted mortality only among non-Estonians, whereas ever smoking was associated with mortality in Estonian men and women. Overweight women had lower mortality risk compared to women in normal weight category. Conclusions We found considerable ethnic variation in SRH–mortality association and in socioeconomic predictors of mortality. Further research, preferably focusing on cause-specific mortality and reporting heterogeneity of SRH could potentially shed further light on ethnic differences in SRH–mortality association in Estonia and more generally on socioeconomic inequalities in mortality in Eastern Europe.

Place, publisher, year, edition, pages
Lithuanian University of Health Sciences, 2017
Keywords
Self-rated health, Mortality, Health inequality, Ethnicity, Eastern Europe, Estonia
National Category
Sociology
Research subject
Baltic and East European studies
Identifiers
urn:nbn:se:sh:diva-32478 (URN)10.1016/j.medici.2017.04.003 (DOI)000404066100006 ()28528770 (PubMedID)2-s2.0-85019375934 (Scopus ID)
Funder
The Foundation for Baltic and East European Studies, 50/2014
Available from: 2017-05-05 Created: 2017-05-05 Last updated: 2022-03-01Bibliographically approved
Reile, R., Stickley, A. & Leinsalu, M. (2017). Large variation in predictors of mortality by levels of self-rated health: Results from an 18-year follow-up study. Public Health, 145, 59-66
Open this publication in new window or tab >>Large variation in predictors of mortality by levels of self-rated health: Results from an 18-year follow-up study
2017 (English)In: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 145, p. 59-66Article in journal (Refereed) Published
Abstract [en]

Objectives: To analyze the variation in factors associated with mortality risk at different levels of self-rated health (SRH).

Study design: Retrospective cohort study.

Methods: Cox regression analysis was used to examine the association between mortality and demographic, socioeconomic and health-related predictors for respondents with good, average, and poor SRH in a longitudinal data set from Estonia with up to 18 years of follow-up time.

Results: In respondents with good SRH, male sex, older age, lower income, manual occupation, ever smoking, and heavy alcohol consumption predicted higher mortality. These covariates, together with marital status, illness-related limitations, and underweight predicted mortality in respondents with average SRH. For poor SRH, only being never married and having illness-related limitations predicted mortality risk in addition to older age and male sex.

Conclusions: The predictors of all-cause mortality are not universal but depend on the level of SRH. The higher mortality of respondents with poor SRH could to a large extent be attributed to health problems, whereas in the case of average or good SRH, factors other than the presence of illness explained outcome mortality.

Place, publisher, year, edition, pages
Elsevier, 2017
Keywords
Self-rated health, Mortality, Health concepts, Estonia
National Category
Sociology
Research subject
Baltic and East European studies
Identifiers
urn:nbn:se:sh:diva-31804 (URN)10.1016/j.puhe.2016.12.034 (DOI)000399629500011 ()28359392 (PubMedID)2-s2.0-85009957605 (Scopus ID)
Funder
The Foundation for Baltic and East European Studies, 50/2014
Available from: 2017-01-20 Created: 2017-01-20 Last updated: 2022-03-01Bibliographically approved
Reile, R., Stickley, A. & Leinsalu, M. (2017). Re: Letter to the Editor of Public Health in response to ‘Large variation in predictors of mortality by levels of self-rated health: results from an 18-year follow-up study’ [Letter to the editor]. Public Health, 147, 157-158
Open this publication in new window or tab >>Re: Letter to the Editor of Public Health in response to ‘Large variation in predictors of mortality by levels of self-rated health: results from an 18-year follow-up study’
2017 (English)In: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 147, p. 157-158Article in journal, Letter (Refereed) Published
Place, publisher, year, edition, pages
Elsevier, 2017
National Category
Sociology
Research subject
Baltic and East European studies; Baltic and East European studies
Identifiers
urn:nbn:se:sh:diva-32747 (URN)10.1016/j.puhe.2017.03.017 (DOI)000405833500027 ()2-s2.0-85019579163 (Scopus ID)
Funder
The Foundation for Baltic and East European Studies, 50/2014
Available from: 2017-06-09 Created: 2017-06-09 Last updated: 2022-03-01Bibliographically approved
Co-InvestigatorStickley, Andrew
Principal InvestigatorLeinsalu, Mall
Coordinating organisation
Södertörn University
Funder
Period
2015-01-01 - 2017-12-31
Keywords [sv]
Östersjö- och Östeuropaforskning
Keywords [en]
Baltic and East European studies
National Category
Sociology (excluding Social Work, Social Psychology and Social Anthropology)
Identifiers
DiVA, id: project:1740Project, id: 50/2014_OSS