Adult Food Security and the Relationship with Adverse Childhood Experiences Among Residents of Appalachian North Carolina.

The Appalachian region has worse health outcomes than the remainder of the United States. These disparities are often linked to the underlying social and environmental determinants of health. Adverse childhood experiences (ACEs) are associated with poor health outcomes across the lifespan and have a significant impact on future social determinants as an adult, including food security status. To explore the relationships between ACEs and food security among adults in the Appalachian counties of North Carolina and make comparisons with the rest of the state. Researchers used North Carolina's 2012 Behavioral Risk Factor Surveillance System data; namely, the ACEs optional module which includes 11 items related to experiences respondents had before the age of 18 and a single item from the Social Context optional module to classify food security status. The sample was divided into three age categories (18-44, 45-64, and 65 and older) for statistical comparisons as well as by the indicator for Appalachian county. Using Stata 15, weighted logistic regression was utilized for examining relationships between variables. ACEs were a statistically significant predictor of food insecurity across all respondents; each additional ACE was associated with a 13-21% increase in the odds of food insecurity, depending on age group. However, living in an Appalachian county was only a predictor for those age 45-64. These findings highlight the long-term effects of childhood experiences on food security generally, and in Appalachia particularly for middle-aged adults. Reducing ACEs could reduce food insecurity and improve health in the region.

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Copyright © 2019 Manan Roy, Erin Bouldin, Maggie Bennett, and Adam Hege.