Gender Differences in the Association Between Adverse Childhood Experiences and Health Risk Behaviors in the Mountain West

Introduction:Recent evidence suggests that adults in the Mountain West region report a higher prevalence of Adverse Childhood Experiences (ACEs) than at the national level.Although the associations between ACEs and adult health risk behaviors such as smoking and problematic alcohol use are well established, whether those associations vary by gender is unclear.Applying a gendered life-course perspective, this study examines the associations between ACEs and adult health risk behaviors. Methods: This cross-sectional study analyzed 2020 Behavioral Risk FactorSurveillance System (BRFSS) data from six Mountain West states using Poisson regression models.Results: Of the 40,795 participants, 69% reported the prevalence of at least one ACE.Women had a higher prevalence of experiencing sexual abuse, living with a household member with mental illness, and living with a household member with substance use disorders compared to their male counterparts.Women also reported significantly more exposure to ACEs on average than men.While women in general reported significantly lower prevalence of adult health risk behaviors than men, with every one-unit increase in ACE score, women had a significantly higher prevalence of ever smoking and binge drinking than men (adjusted Prevalence Ratio [aPR] = 1.04, 95% CI, 1.02-1.06,and aPR = 1.10, 95% CI, 1.06-1.15respectively). Conclusions:The relationship between ACEs and adult health risk behaviors varies by gender.Therefore, the findings support gender-responsive prevention measures for ACEs and the implementation of intervention programs to minimize adult health risk behaviors in the Mountain West region.