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A Canadian look at the connection between childhood maltreatment and diabetes Published: ()
What we know
Child abuse may hurt the body for years after it ends. Reducing child abuse, then, will not only reduce immediate pain, injury and suffering, but may also improve adults’ long-term physical health.
Child maltreatment, including physical and sexual abuse and exposure to intimate partner violence, is a serious public health issue. The links between childhood abuse and teenagers’ and adults’ psychological problems, such as suicidal ideation and attempts, post-traumatic stress disorder, depression and substance abuse, are well known [Afifi et al., 2014]; [Tonmyr & Shields, 2016]. Current research is focusing on the lesser known long-term consequences of child maltreatment and the development of chronic physical health conditions.
“Childhood experiences, both positive and negative, have a tremendous impact on future violence victimization and perpetration, and lifelong health and opportunity.” [CDC, 2016]
Findings from the Adverse Childhood Experiences (ACEs) Study from the US support the link between adverse childhood experiences, and certain long-term chronic diseases such as cancer, heart disease and diabetes in adulthood. A 2015 systematic review and meta-analysis using the ACEs found that adverse childhood experiences, including physical abuse, sexual abuse or neglect, were associated with an elevated risk of developing type 2 diabetes in adulthood. This is thought to be due to ACEs acting as chronic stressors on the body by triggering elevated levels of triglycerides, free fatty acids, glucose and insulin in the blood as well as other markers of inflammation. [Huang et al., 2015]
Studies from Canada are showing similar findings.
What we looked at
Some people experience more severe child maltreatment than others. People might get hit once, or repeatedly, with or without dangerous objects. Similarly, sexual abuse may happen only once or may continue, and may involve more or less intrusive acts. New research allows the exploration and better understanding of the importance of severity to health outcomes later in life.
The 2012 Canadian Community Health Survey – Mental Health (CCHS-MH) was nationally representative and included responses from over 25,000 Canadians. A recent study based on the CCHS-MH [Shields et al., 2016] found that childhood maltreatment was associated with diabetes. In the survey, respondents were asked to report on long-term health conditions diagnosed by a health professional. Adults were also asked a series of questions about experiences of childhood physical or sexual abuse or exposure to intimate partner violence before they were 16 years old.
What we found
The study found that the frequency (e.g. if the abuse happened more than three times), the type of abuse (physical, sexual or both) and the severity of the abuse (e.g. punching, choking or burning) seemed to affect the risk of developing diabetes. Specifically the study found that:
- Those who frequently experienced severe childhood sexual abuse were twice as likely to have diabetes than those who did not experience childhood sexual abuse.
- Experiencing more than one type of childhood abuse increased the likelihood of having diabetes as an adult.
- Those who frequently experienced severe childhood physical and sexual abuse were over two times more likely to have diabetes than those who experienced no abuse of either type.
To verify the connection between childhood maltreatment and diabetes, we isolated the effects of other known factors that contribute to the risk of developing diabetes such as obesity, smoking status, physical activity level, high blood pressure, age, gender, and income. After this verification, the connection between childhood maltreatment and diabetes remained.
Few studies have examined associations between childhood maltreatment and diabetes using large population-based samples. Therefore studies such as this one, of a representative sample of Canadian adults, are important in highlighting the life-long health consequences of experiencing family violence in childhood.
What this means for public health
Diabetes is the sixth leading cause of death in Canada and increases the risk of developing a number of additional long-term health issues such as heart disease and stroke. The proportion of Canadians living with diabetes has almost doubled from 6% in 2000 to 10% in 2011. Understanding the role of childhood maltreatment as a risk factor for diabetes, and other life-long health issues, is needed in order to inform treatment of this illness. It also underscores the need to focus on both research and evidence based prevention efforts to address violence against children in the family setting. Working to reduce child maltreatment now could have positive mental and physical health implications for Canadians down the road.
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