Associations between adverse childhood experiences and cardiometabolic health in later adulthood in Colombia

Background Adverse childhood experiences (ACEs) are traumatic events that occur before a child reaches the age of 15 with long-term health consequences, economic costs and intergenerational challenges for society. This study investigated the association between ACEs and cardiometabolic risk (cardiovascular disease (CVD), diabetes, hypertension and obesity) in adulthood. Methods We used data from the Survey on Health, Well-Being and Ageing (SABE)-Colombia (n=18 044 adults aged >65). Exposures were defined as single and cumulative ACEs score. Logistic regression, adjusted for demographics and socioeconomic position, was used to investigate associations. Results 41.3% reported at least one ACE and 4.2% reported four or more. Associations between individual ACEs and outcomes differed by gender. In women, exposure to all ACEs, except childhood migration, was associated with increased odds of CVD, for example, emotional abuse (OR=1.69 (95% CI 1.32 to 2.13)) and poor childhood health status (OR=1.64 (95% CI 1.39 to 1.91)). Among men, these associations were much weaker and often non-statistically significant, except childhood migration that showed increased odds of CVD (OR=1.55 (95% CI 1.09 to 2.15), diabetes (OR=1.55 (95% CI 1.11 to 2.14)) and hypertension (OR=1.40 (95% CI 1.07 to 1.83) in adulthood). A significant association was observed between cumulative ACEs score and odds of CVD, diabetes and hypertension in both men and women. This pattern was not observed for obesity. Conclusion The long-term health consequences of ACEs differ by gender. Longitudinal studies are needed to establish causality and identify mediators. Public health interventions should adopt gender-sensitive, holistic approaches integrating biological, environmental, social and behavioural dimensions, and prioritise early-life interventions to address long-term health inequalities.