PT  - JOURNAL ARTICLE
AU  - David Walsh
AU  - Gerry McCartney
AU  - Michael Smith
AU  - Gillian Armour
TI  - Relationship between childhood socioeconomic position and adverse childhood experiences (ACEs): a systematic review
AID  - 10.1136/jech-2019-212738
DP  - 2019 Dec 01
TA  - Journal of Epidemiology and Community Health
PG  - 1087--1093
VI  - 73
IP  - 12
4099  - http://jech.bmj.com/content/73/12/1087.short
4100  - http://jech.bmj.com/content/73/12/1087.full
SO  - J Epidemiol Community Health2019 Dec 01; 73
AB  - Background ‘Adverse childhood experiences’ (ACEs) are associated with increased risk of negative outcomes in later life: ACEs have consequently become a policy priority in many countries. Despite ACEs being highly socially patterned, there has been very little discussion in the political discourse regarding the role of childhood socioeconomic position (SEP) in understanding and addressing them. The aim here was to undertake a systematic review of the literature on the relationship between childhood SEP and ACEs.Methods MEDLINE, PsycINFO, ProQuest and Cochrane Library databases were searched. Inclusion criteria were: (1) measurement of SEP in childhood; (2) measurement of multiple ACEs; (3) ACEs were the outcome; and (4) statistical quantification of the relationship between childhood SEP and ACEs. Search terms included ACEs, SEP and synonyms; a second search additionally included ‘maltreatment’. Overall study quality/risk of bias was calculated using a modified version of the Hamilton Tool.Results In the ACEs-based search, only 6 out of 2825 screened papers were eligible for qualitative synthesis. The second search (including maltreatment) increased numbers to: 4562 papers screened and 35 included for synthesis. Eighteen papers were deemed ‘high’ quality, five ‘medium’ and the rest ‘low’. Meaningful statistical associations were observed between childhood SEP and ACEs/maltreatment in the vast majority of studies, including all except one of those deemed to be high quality.Conclusion Lower childhood SEP is associated with a greater risk of ACEs/maltreatment. With UK child poverty levels predicted to increase markedly, any policy approach that ignores the socioeconomic context to ACEs is therefore flawed.PROSPERO registration number CRD42017064781.