652 - Adverse Childhood Experiences, Obesity Risk, and Atopic Diagnoses in Flint Children

Adverse childhood experiences (ACEs; e.g., violence, parental separation, financial hardship) increase morbidity, in part, through chronic psychosocial stress-induced changes to immune, cardiovascular, and endocrine development. ACEs and psychosocial stress increase a child’s risk of developing atopic conditions (e.g., asthma, allergies, and eczema) and possibly obesity. Children in Flint, Michigan, face significant psychosocial- and poverty-related stressors, and additionally, the Flint water crisis (FWC) exposed thousands of children to community-level trauma and lead, a neurotoxin that may also alter immune function with implications for inflammatory disorders. Less is known about the association between ACEs and immune-mediated conditions in the context of population-wide trauma and lead exposure.

Objective:

To assess the prevalence of ACEs and associations between the accumulation of ACEs and the incidence of overweight or obesity (OO) and atopic disorders in young children in Flint post-FWC.

Design/Methods:

Following exposure to FWC, N=184 child (4- to 6-year-olds) and mother dyads participated in a lab visit. Parents completed a survey concerning their child’s exposure to 8 types of ACEs (e.g., parental separation, violence, economic hardship, drug abuse). Parents reported diagnosis of asthma, allergies, or eczema. Child height and weight were measured, BMI-for-age %iles were calculated. N=153 had complete data on analysis variables. Logistic and Poisson regression assessed associations between ACE accumulation and OO and the count of atopic diagnoses, respectively. Models controlled for parent education and child age.

Results:

18% and 24% of children were exposed to 1 and 2 or more ACEs, respectively. 35% were OO and 44% had been diagnosed with either asthma, allergies, or eczema. Compared to those exposed to 0 ACEs, the count of atopic diagnoses was 82% higher for children exposed to 1 ACE (IRR=1.82, p=.009) and was 42% higher for children exposed to 2 or more ACEs (IRR=1.42, p=.11), although this ladder finding was not significant at p< .05. There was no association between ACEs and odds of OO (ps >.50).

Conclusion(s):

Atop the FWC, Flint children were exposed to many ACEs by 4-6 years of age and there is some evidence that ACEs predicted atopic medical conditions at this early age. Because psychosocial stress may exacerbate the negative effects of both lead and community-level stress, and due to the long-term manifestations of adversity, support and follow up is needed to understand factors contributing to risk and resilience.