The impact of Adverse Childhood Experiences on social determinants among Saudi adults.

Background: Early exposure to violence has deleterious effect on the child's brain development. The aims for this project were to assess the prevalence of Adverse Childhood Experiences (ACEs) and their impact on social determinants in Saudi Arabia (SA).

Methods: A cross-sectional, national study conducted in all regions of SA using the World Health Organization-ACE-International Questionnaire to determine the association between ACEs and socioeconomic outcomes.

Results: A total of 10 156 participants completed the questionnaire with five main ACE categories (abuse, neglect, family dysfunction, peer and community violence). Over half of the sample (52%) experienced emotional abuse, followed by physical abuse (42%), bullying (39%), neglect (29%) and sexual abuse (21%). The most common family dysfunction was witnessing domestic violence against any household member (57%) and the least prevalent was living with a substance abuser (9%). Low educational attainment, disruption in marital life and substance abuse were significantly affected by all ACE categories. However, unemployment was marginally affected only by neglect and household dysfunction.

Conclusions: ACEs are highly prevalent in SA and have significant negative impact on life opportunities. National preventive programs should be implemented to reduce ACE and their deleterious outcomes.