http://www.iowaaces360.org/uploads/1/0/9/2/10925571/relationship_of_childhood_abuse_and..._1998.pdf

Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study

WRITING GROUP MEMBERS Emelia J. Benjamin, MD, SCM, FAHA Michael J. Blaha, MD, MPH Stephanie E. Chiuve, ScD Mary Cushman, MD, MSc, FAHA Sandeep R. Das, MD, MPH, FAHA Rajat Deo, MD, MTR Sarah D. de Ferranti, MD, MPH James Floyd, MD, MS Myriam Fornage, PhD, FAHA Cathleen Gillespie, MS Carmen R. Isasi, MD, PhD, FAHA Monik C. Jiménez, ScD, SM Lori Chaffin Jordan, MD, PhD Suzanne E. Judd, PhD Daniel Lackland, DrPH, FAHA Judith H. Lichtman, PhD, MPH, FAHA Lynda Lisabeth, PhD, MPH, FAHA Simin Liu, MD, ScD, FAHA Chris T. Longenecker, MD Rachel H. Mackey, PhD, MPH, FAHA Kunihiro Matsushita, MD, PhD, FAHA Dariush Mozaffarian, MD, DrPH, FAHA Michael E. Mussolino, PhD, FAHA Khurram Nasir, MD, MPH, FAHA Robert W. Neumar, MD, PhD, FAHA Latha Palaniappan, MD, MS, FAHA Dilip K. Pandey, MBBS, MS, PhD, FAHA Ravi R. Thiagarajan, MD, MPH Mathew J. Reeves, PhD Matthew Ritchey, PT, DPT, OCS, MPH Carlos J. Rodriguez, MD, MPH, FAHA Gregory A. Roth, MD, MPH Wayne D. Rosamond, PhD, FAHA Comilla Sasson, MD, PhD, FAHA Amytis Towfighi, MD Connie W. Tsao, MD, MPH Melanie B. Turner, MPH Salim S. Virani, MD, PhD, FAHA Jenifer H. Voeks, PhD Joshua Z. Willey, MD, MS John T. Wilkins, MD Jason HY. Wu, MSc, PhD, FAHA Heather M. Alger, PhD Sally S. Wong, PhD, RD, CDN, FAHA Paul Muntner, PhD, MHSc On behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee Heart Disease and Stroke Statistics—2017 Update

Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association

Author(s): Writing Group Members; Mozaffarian, Dariush; Benjamin, Emelia J; Go, Alan S; Arnett, Donna K; Blaha, Michael J; Cushman, Mary; Das, Sandeep R; de Ferranti, Sarah; Despres, Jean-Pierre; Fullerton, Heather J; Howard, Virginia J; Huffman, Mark D; Isasi, Carmen R; Jimenez, Monik C; Judd, Suzanne E; Kissela, Brett M; Lichtman, Judith H; Lisabeth, Lynda D; Liu, Simin; Mackey, Rachel H; Magid, David J; McGuire, Darren K; Mohler, Emile R; Moy, Claudia S; Muntner, Paul; Mussolino, Michael E; Nasir, Khurram; Neumar, Robert W; Nichol, Graham; Palaniappan, Latha; Pandey, Dilip K; Reeves, Mathew J; Rodriguez, Carlos J; Rosamond, Wayne; Sorlie, Paul D; Stein, Joel; Towfighi, Amytis; Turan, Tanya N; Virani, Salim S; Woo, Daniel; Yeh, Robert W; Turner, Melanie B; American Heart Association Statistics Committee; Stroke Statistics Subcommittee

Heart Disease and Stroke Statistics—2016 Update: A Report From the American Heart Association

The world report on violence and health.

Context Obesity and diabetes are increasing in the United States. Objective To estimate the prevalence of obesity and diabetes among US adults in 2001. Design, Setting, and Participants Random-digit telephone survey of 195 005 adults aged 18 years or older residing in all states participating in the Behavioral Risk Factor Surveillance System in 2001. Main Outcome Measures Body mass index, based on self-reported weight and height and self-reported diabetes. Results In 2001 the prevalence of obesity (BMI ≥30) was 20.9% vs 19.8% in 2000, an increase of 5.6%. The prevalence of diabetes increased to 7.9% vs 7.3% in 2000, an increase of 8.2%. The prevalence of BMI of 40 or higher in 2001 was 2.3%. Overweight and obesity were significantly associated with diabetes, high blood pressure, high cholesterol, asthma, arthritis, and poor health status. Compared with adults with normal weight, adults with a BMI of 40 or higher had an odds ratio (OR) of 7.37 (95% confidence interval [CI], 6.39-8.50) for diagnosed diabetes, 6.38 (95% CI, 5.67-7.17) for high blood pressure, 1.88 (95% CI,1.67-2.13) for high cholesterol levels, 2.72 (95% CI, 2.38-3.12) for asthma, 4.41 (95% CI, 3.91-4.97) for arthritis, and 4.19 (95% CI, 3.68-4.76) for fair or poor health. Conclusions Increases in obesity and diabetes among US adults continue in both sexes, all ages, all races, all educational levels, and all smoking levels. Obesity is strongly associated with several major health risk factors.

https://jamanetwork.com/journals/jama/articlepdf/195663/jbr20304_76_79.pdf

Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001.

In Reply.— The success of Dr Duh's approach to smoking cessation is probably related to his including most of the key elements of the minimal smokingcessation procedure, which are as follows: (1) asking all patients about their smoking habits, (2) delivering a firm quit-smoking message, (3) agreeing on a quitting date, and (4) following up on the patient's progress during each visit. 1 If every medical student were taught this basic approach to smoking cessation (just as they are taught the ABCs of resuscitation), more physicians would feel prepared to counsel patients to quit smoking. With regard to Dr Duh's comments on the issue of financial reimbursement for counseling smokers, it is important to note that most smokers are healthy early in the course of their smoking history and thus may not have regular contact with their physicians. For those patients who are trying to quit, appropriate reimbursement for follow-up

Are Physicians Advising Smokers to Quit?-Reply

508 Adverse Childhood Experiences and Gastrointestinal Symptoms in Adulthood

To the Editor. —We are writing to respond to the article by Blum1entitled "Contemporary Threats to Adolescent Health in the United States" that appeared in the June 26 issue ofJAMA. Dr Blum's article provides a comprehensive perspective on the health problems that today's teenagers face in our society. Problems such as injuries, violence, and teenage pregnancies are immediate and compelling concerns for physicians who care for adolescents. Although Dr Blum mentions tobacco and alcohol abuse, other significant threats to the future cardiovascular health of adolescents, such as obesity, physical inactivity, elevated blood cholesterol level, and high blood pressure, are not discussed. The life-styles and health habits that influence the major modifiable risk factors for adult cardiovascular disease are adopted during early childhood and adolescence.2Unfortunately, efforts to prevent cardiovascular disease usually are delayed until these behaviors are firmly established in adult life. The resulting emphasis on

Cardiovascular risk factors and the adolescent.

Background:�Fewreportsha vead dressedas sociations� betweenfamilyst rengthsdu ringch ildhoodan dad oles- centpregnancyan dit sco nsequences.� Weex amined� relationshipsam onganu mberofch ildhoodfa mily� strengthsandad olescentpr egnancy,�ri skbe havior,�an d� psychosocialco nsequencesaf terad olescentpr egnancy. Methods:� Ourretrospectiveco hortof� 46 48� wo men� olderthan�18�ye ars�(m eanag e,�56�ye ars)�re ceivedpr imary� careinSanDi ego,�CA .�Ou tcomesin cludedad olescent� pregnancyan dps ychosocialco nsequencesco mpared� withnumberofth efo llowingch ildhoodfa milyst rengths:� familycloseness,�su pport,�lo yalty,�pr otection,�lo ve,�im- portance,�andre sponsivenesstohe althne eds. Results:�Ofthecohort,�3082�participants�(66%)�re- ported�6�or�7�categoriesofchildhoodfamilystrengths.� Teenpregnancyoc curredin� 39 %,� 33 %,� 30 %,� 25 %,� 24%,�21%,�and�19%�ofthosewith�0�or�1,�2,�3,�4,�5,� 6,�and�7�childhoodfamilystrengths,�respectiv ely�(pfor� trend�<�0.00001).�Wh ench ildhoodab usean dho usehold� dysfunctionwerepresent,� adjustedoddsratios� (ORs)� foradolescentpr egnancyde monstratedanin creasingly� protectiveeffectasnu mbersofch ildhoodfa milyst rengths� increasedfrom�0�or�1�to�2�or�3,�4�or�5,�an d�6�or�7�(1 .0�to� 0.80),�(1.0�to�0. 80,�0.60,�and�0.54,�respectiv ely).�These� findingswerepartlyexplainedbyprogressiv edelaysin� initiationofsexualactivityasthenumberofchildhood� familystrengthsincreased.�AdjustedORsforpsychoso- cialproblemoccurringdecadeslaterdecreasedasthe� numberofchildhoodfamilystrengthsincreasedfrom�0� or�1�to�2�or�3,�4�or�5,�and�6�or�7�(jobproblems,�1.0,�0.8,� 0.6,�0.4;�familyproblems,�1.0,�1.1,�0.7,�0.6;�financial � problems,�1.0,�0.9,�0.9,�0.6;�highstress,�1.0,�1.1,�0.9,� 0.8;�uncontrollableanger,�1.0,�0.7,�0.7,�0.4).

TheProtectiveEffectofFamilyStrengthsinChildhood againstAdolescentPregnanc yandItsLong-T erm PsychosocialConsequences

/pdf/women-a-retrospective-study-adverse-childhood-experiences-25vz3bqwc8.pdf

Robert F. Anda

Papers

Are Physicians Advising Smokers to Quit?-Reply

508 Adverse Childhood Experiences and Gastrointestinal Symptoms in Adulthood

Cardiovascular risk factors and the adolescent.

TheProtectiveEffectofFamilyStrengthsinChildhood againstAdolescentPregnanc yandItsLong-T erm PsychosocialConsequences

Women: A Retrospective Study Adverse Childhood Experiences and Sexually Transmitted Diseases in Men and