Adverse Childhood Experiences and living in the socially deprived areas in adulthood: A cross-sectional study of the nationwide data in Japan

Objectives: This study aimed to examine whether having adverse childhood experiences (ACEs) was associated with living in a deprived area in adulthood. Methods: The cross-sectional study was conducted by using nationwide data in 2022 of the Japan COVID-19 and Society Internet Survey (JACSIS). Participants were community dwelling people 18 years or older. ACEs were assessed by Japanese version of 15-items ACE measurement tool (ACE-J). Living condition was measured by Area Deprived Index (ADI) and Densely Inhabited District (DID) based on zip code. Multivariable logistic regression to analyze the associations between ADI and ACE 4+ was conducted, controlling for individual-level factors, such as age, sex, marital status, and education, as an additional analysis. Results: The total of 27,967 participants were included in the analysis. The prevalence of emotional neglect, childhood poverty, and school bullying were 34.5%, 21.9%, 20.0%, respectively. More than 70.1% of the population had one or more ACE(s). The number of ACEs was associated with significantly higher risk of living in deprived area in the adulthood (p<0.001). ACEs were not associated with living in density area. The association between ADI and ACEs 4+ was non-significant after controlling the individual-level factors. Conclusion: People with higher number of ACEs tend to live in deprived areas in adulthood. Policy makers in highly deprived areas can apply the trauma-informed approach for the community care and support, which is critical to mitigating deficit perspectives and facilitating comprehensive support for those who experience ACEs.