Do Adverse Early Life Experiences in the Jewish Community Result in Worse Health Outcomes?

Abstract

Background: At-risk behaviors have been identified in adolescent and young adult populations from Orthodox Jewish communities. Factors hypothesized to be associated with at-risk behaviors in these populations include adverse childhood experiences (ACEs) and poor family functioning. Additionally, both ACEs and family functioning have been found to predict health outcomes including chronic and other diseases, health-related quality of life (HRQOL), somatic symptoms and health habits. Research on the childhood adversity-health relationship is well established in general populations, as is research on the relationship between family functioning and health. While cultural factors contribute to childhood adversity, family functioning, and health, research on the impact of these relationships within Orthodox Jewish populations is limited. The aim of the current study was twofold: (1) to examine differences between an at-risk and control. group of Orthodox Jewish young adults on measures of ACEs and family functioning and (2) to examine the impact of ACEs and family functioning on HRQOL, somatic symptoms, and health habits in a young Orthodox Jewish sample.;Methods: Participants were 296 Orthodox Jewish young adults (Mage= 21.6 years, 53.4% female), with data completed by 163 participants from a Yeshiva University based control group and 52 participants from a Project Extreme based at-risk group Online measures of ACE, family functioning, HRQOL, somatic symptoms, and health habits were completed.;Results: Consistent with previous literature, compared to controls, participants from the at-risk group endorsed significantly more ACEs (t(56.5) = -7.46,p < .001) and significantly lower levels of productive family functioning (t(70.45) = 5.62,p < .001) overall. When both groups were examined together, regression analyses indicated that family functioning significantly predicted HRQOL (beta = -.33, p < .001, 95% CI [-.06, -.03]), somatic symptoms (beta = -.24, p < .01, 95% CI [-.03, -.01]), and health habits (beta = .30 p < .001, 95% CI [.22, .61]) in the expected directions. Contrary to hypotheses, however, ACEs failed to significantly predict any of the three health outcome variables, although a trend was indicated for the effect of ACE on HRQOL (beta = .13,p = .07, 95% CI [-.01, .20]) and somatic symptoms (beta,= .15p = .08, 95% CI [.00, -.17]). Follow-up mediation analyses found family functioning to be a significant mediator of the relationship between ACE and each health outcome in the current study: HRQOL (ab = .08, 95% CI [.04, .14]), somatic symptoms (ab = .03, 95% CI [01, .08]), and health habits (ab = -.81, 95% CI [-1.58, -0.29]). Results were maintained after adjusting for age, gender, and group affiliation.;Conclusions: The current study confirms the impact of ACEs and family functioning on at-risk group affiliation, and implicates family functioning as the link between ACEs and health outcomes in young adults from the Orthodox Jewish community. Productive family functioning may be particularly important for children with histories of childhood adversity and children living within insular Orthodox communities. This has implications for treatment, which may need to address family functioning with young populations exposed to early life adversity to prevent the development of poor health.