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Adverse Childhood Experiences: Health Care Utilization And Expenditures In Adulthood.
Thomas M Selden1, Didem M Bernard2, Sandra L Decker3
1Thomas M. Selden (Thomas.Selden@ahrq.hhs.gov), Agency for Healthcare Research and Quality, Rockville, Maryland.
Health Affairs (Project Hope)
|July 24, 2024
Summary
Adverse childhood experiences (ACEs) are linked to higher healthcare use and costs. Adults with ACEs incurred 26.3% more healthcare spending, totaling $292 billion in 2021.
Area of Science:
- Public Health
- Health Economics
- Psychology
Background:
- Adverse childhood experiences (ACEs) are established predictors of long-term health and socioeconomic outcomes.
- The association between ACEs and adult healthcare utilization and expenditures remains less understood.
Purpose of the Study:
- To provide nationally representative estimates of ACEs-related healthcare utilization and expenditure differences.
- To examine the direct relationship between ACEs and adult healthcare costs using recent survey data.
Main Methods:
- Utilized data from the 2021 Medical Expenditure Panel Survey-Household Component (MEPS-HC).
- Compared healthcare utilization and expenditures between adults with and without reported ACEs.
- Calculated aggregate spending differences for US adults with ACEs.
Main Results:
- Adults with ACEs exhibited significantly higher healthcare utilization and 26.3% greater expenditures compared to those without ACEs.
- The estimated aggregate healthcare expenditure difference attributed to ACEs was $292 billion in 2021 for 157.6 million US adults.
- Found graded relationships between ACEs and poorer health status, adverse health behaviors, and socioeconomic disadvantages.
Conclusions:
- ACEs are associated with substantially increased adult healthcare utilization and costs.
- The findings highlight the significant economic burden of ACEs on the healthcare system.
- ACEs are linked to a spectrum of adverse adult circumstances, underscoring the need for early intervention and support.
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