{"id":"https://openalex.org/W4410171233","doi":"https://doi.org/10.1353/hpu.2025.a959111","title":"Rural-Urban Differences in the Prevalence of Adverse Childhood Experiences Following the COVID-19 Pandemic","display_name":"Rural-Urban Differences in the Prevalence of Adverse Childhood Experiences Following the COVID-19 Pandemic","publication_year":2025,"publication_date":"2025-05-01","ids":{"openalex":"https://openalex.org/W4410171233","doi":"https://doi.org/10.1353/hpu.2025.a959111","pmid":"https://pubmed.ncbi.nlm.nih.gov/40351202"},"language":"en","primary_location":{"id":"doi:10.1353/hpu.2025.a959111","doi":"https://doi.org/10.1353/hpu.2025.a959111","is_oa":false,"landing_page_url":"https://doi.org/10.1353/hpu.2025.a959111","pdf_url":null,"source":{"id":"https://openalex.org/S99400149","display_name":"Journal of Health Care for the Poor and Underserved","issn_l":"1049-2089","issn":["1049-2089","1548-6869"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","jufo-1","medline","norway-1"],"host_organization":"https://openalex.org/P4310315678","host_organization_name":"Johns Hopkins University Press","host_organization_lineage":["https://openalex.org/P4310315678","https://openalex.org/P4310316510"],"host_organization_lineage_names":["Johns Hopkins University Press","Johns Hopkins University"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Health Care for the Poor and Underserved","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5023324921","display_name":"Emma Kathryn Boswell","orcid":"https://orcid.org/0009-0006-3704-1182","observed_orcids":["https://orcid.org/0009-0006-3704-1182"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Emma Boswell","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5053119432","display_name":"Elizabeth L. Crouch","orcid":"https://orcid.org/0000-0002-5380-8391","observed_orcids":["https://orcid.org/0000-0002-5380-8391"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Elizabeth Crouch","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5061494397","display_name":"Cassie Lewis Odahowski","orcid":"https://orcid.org/0000-0003-0075-6863","observed_orcids":["https://orcid.org/0000-0003-0075-6863"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Cassie Odahowski","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"last","author":{"id":"https://openalex.org/A5056134153","display_name":"Peiyin Hung","orcid":"https://orcid.org/0000-0002-1529-0819","observed_orcids":["https://orcid.org/0000-0002-1529-0819"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Peiyin Hung","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]}],"institutions":[],"countries_distinct_count":0,"institutions_distinct_count":0,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":1.1752,"has_fulltext":false,"cited_by_count":1,"citation_normalized_percentile":{"value":0.7602366,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":90,"max":94},"biblio":{"volume":"36","issue":"2","first_page":"508","last_page":"525"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10426","display_name":"Child Abuse and Trauma","score":0.9984999895095825,"subfield":{"id":"https://openalex.org/subfields/3203","display_name":"Clinical Psychology"},"field":{"id":"https://openalex.org/fields/32","display_name":"Psychology"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},"topics":[{"id":"https://openalex.org/T10426","display_name":"Child Abuse and Trauma","score":0.9984999895095825,"subfield":{"id":"https://openalex.org/subfields/3203","display_name":"Clinical Psychology"},"field":{"id":"https://openalex.org/fields/32","display_name":"Psychology"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T11380","display_name":"Child Welfare and Adoption","score":0.00039999998989515007,"subfield":{"id":"https://openalex.org/subfields/3311","display_name":"Safety Research"},"field":{"id":"https://openalex.org/fields/33","display_name":"Social Sciences"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T10168","display_name":"COVID-19 and Mental Health","score":0.0003000000142492354,"subfield":{"id":"https://openalex.org/subfields/3203","display_name":"Clinical Psychology"},"field":{"id":"https://openalex.org/fields/32","display_name":"Psychology"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/adverse-childhood-experiences","display_name":"adverse childhood experiences","score":1.0},{"id":"https://openalex.org/keywords/urban-rural-differences","display_name":"urban-rural differences","score":0.9729999899864197},{"id":"https://openalex.org/keywords/covid-19","display_name":"COVID-19 pandemic","score":0.9879999756813049},{"id":"https://openalex.org/keywords/child-poverty","display_name":"child poverty","score":0.7179999947547913},{"id":"https://openalex.org/keywords/household-income","display_name":"household income","score":0.9959999918937683},{"id":"https://openalex.org/keywords/racial-discrimination","display_name":"racial discrimination","score":0.8650000095367432},{"id":"https://openalex.org/keywords/rural-children","display_name":"rural children","score":0.7110000252723694},{"id":"https://openalex.org/keywords/national-health-interview-survey","display_name":"National Health Interview Survey","score":0.7940000295639038}],"concepts":[{"id":"https://openalex.org/C2779465365","wikidata":"https://www.wikidata.org/wiki/Q7380600","display_name":"Rurality","level":3,"score":0.9123026132583618},{"id":"https://openalex.org/C143095724","wikidata":"https://www.wikidata.org/wiki/Q515895","display_name":"Odds","level":3,"score":0.7979920506477356},{"id":"https://openalex.org/C189326681","wikidata":"https://www.wikidata.org/wiki/Q10294","display_name":"Poverty","level":2,"score":0.6127917766571045},{"id":"https://openalex.org/C89623803","wikidata":"https://www.wikidata.org/wiki/Q12184","display_name":"Pandemic","level":5,"score":0.5691637992858887},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.5276264548301697},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.4789317548274994},{"id":"https://openalex.org/C129047720","wikidata":"https://www.wikidata.org/wiki/Q175185","display_name":"Rural area","level":2,"score":0.460636705160141},{"id":"https://openalex.org/C3008058167","wikidata":"https://www.wikidata.org/wiki/Q84263196","display_name":"Coronavirus disease 2019 (COVID-19)","level":4,"score":0.4583451449871063},{"id":"https://openalex.org/C156957248","wikidata":"https://www.wikidata.org/wiki/Q1862216","display_name":"Odds ratio","level":2,"score":0.42662927508354187},{"id":"https://openalex.org/C149923435","wikidata":"https://www.wikidata.org/wiki/Q37732","display_name":"Demography","level":1,"score":0.40556371212005615},{"id":"https://openalex.org/C45355965","wikidata":"https://www.wikidata.org/wiki/Q1643441","display_name":"Socioeconomics","level":1,"score":0.3216784596443176},{"id":"https://openalex.org/C151956035","wikidata":"https://www.wikidata.org/wiki/Q1132755","display_name":"Logistic regression","level":2,"score":0.23442411422729492},{"id":"https://openalex.org/C50522688","wikidata":"https://www.wikidata.org/wiki/Q189833","display_name":"Economic growth","level":1,"score":0.13873127102851868},{"id":"https://openalex.org/C144024400","wikidata":"https://www.wikidata.org/wiki/Q21201","display_name":"Sociology","level":0,"score":0.09445664286613464},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.07445916533470154},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.0},{"id":"https://openalex.org/C142724271","wikidata":"https://www.wikidata.org/wiki/Q7208","display_name":"Pathology","level":1,"score":0.0},{"id":"https://openalex.org/C162324750","wikidata":"https://www.wikidata.org/wiki/Q8134","display_name":"Economics","level":0,"score":0.0},{"id":"https://openalex.org/C524204448","wikidata":"https://www.wikidata.org/wiki/Q788926","display_name":"Infectious disease (medical specialty)","level":3,"score":0.0}],"mesh":[{"descriptor_ui":"D000076783","descriptor_name":"Adverse Childhood Experiences","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D000076783","descriptor_name":"Adverse Childhood Experiences","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D000076783","descriptor_name":"Adverse Childhood Experiences","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D000086382","descriptor_name":"COVID-19","qualifier_ui":"Q000453","qualifier_name":"epidemiology","is_major_topic":true},{"descriptor_ui":"D000086382","descriptor_name":"COVID-19","qualifier_ui":"Q000453","qualifier_name":"epidemiology","is_major_topic":true},{"descriptor_ui":"D000086382","descriptor_name":"COVID-19","qualifier_ui":"Q000453","qualifier_name":"epidemiology","is_major_topic":true},{"descriptor_ui":"D000086402","descriptor_name":"SARS-CoV-2","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000086402","descriptor_name":"SARS-CoV-2","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000086402","descriptor_name":"SARS-CoV-2","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000293","descriptor_name":"Adolescent","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000293","descriptor_name":"Adolescent","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000293","descriptor_name":"Adolescent","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000328","descriptor_name":"Adult","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000328","descriptor_name":"Adult","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000328","descriptor_name":"Adult","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D002648","descriptor_name":"Child","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D002648","descriptor_name":"Child","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D002648","descriptor_name":"Child","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D002675","descriptor_name":"Child, Preschool","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D002675","descriptor_name":"Child, Preschool","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D002675","descriptor_name":"Child, Preschool","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006306","descriptor_name":"Health Surveys","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006306","descriptor_name":"Health Surveys","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006306","descriptor_name":"Health Surveys","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008297","descriptor_name":"Male","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008297","descriptor_name":"Male","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008297","descriptor_name":"Male","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008875","descriptor_name":"Middle Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008875","descriptor_name":"Middle Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008875","descriptor_name":"Middle Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D012424","descriptor_name":"Rural Population","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D012424","descriptor_name":"Rural Population","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D012424","descriptor_name":"Rural Population","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D014481","descriptor_name":"United States","qualifier_ui":"Q000453","qualifier_name":"epidemiology","is_major_topic":false},{"descriptor_ui":"D014481","descriptor_name":"United States","qualifier_ui":"Q000453","qualifier_name":"epidemiology","is_major_topic":false},{"descriptor_ui":"D014481","descriptor_name":"United States","qualifier_ui":"Q000453","qualifier_name":"epidemiology","is_major_topic":false},{"descriptor_ui":"D014505","descriptor_name":"Urban Population","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D014505","descriptor_name":"Urban Population","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D014505","descriptor_name":"Urban Population","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D015995","descriptor_name":"Prevalence","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D015995","descriptor_name":"Prevalence","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D015995","descriptor_name":"Prevalence","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D058873","descriptor_name":"Pandemics","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D058873","descriptor_name":"Pandemics","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D058873","descriptor_name":"Pandemics","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":2,"locations":[{"id":"doi:10.1353/hpu.2025.a959111","doi":"https://doi.org/10.1353/hpu.2025.a959111","is_oa":false,"landing_page_url":"https://doi.org/10.1353/hpu.2025.a959111","pdf_url":null,"source":{"id":"https://openalex.org/S99400149","display_name":"Journal of Health Care for the Poor and Underserved","issn_l":"1049-2089","issn":["1049-2089","1548-6869"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","jufo-1","medline","norway-1"],"host_organization":"https://openalex.org/P4310315678","host_organization_name":"Johns Hopkins University Press","host_organization_lineage":["https://openalex.org/P4310315678","https://openalex.org/P4310316510"],"host_organization_lineage_names":["Johns Hopkins University Press","Johns Hopkins University"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Health Care for the Poor and Underserved","raw_type":"journal-article"},{"id":"pmid:40351202","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/40351202","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of health care for the poor and underserved","raw_type":"Journal Article"}],"best_oa_location":null,"sustainable_development_goals":[{"display_name":"Reduced inequalities","score":1.0,"id":"https://metadata.un.org/sdg/10"},{"display_name":"Good health and well-being","score":0.9940000176429749,"id":"https://metadata.un.org/sdg/3"},{"display_name":"No poverty","score":0.41670000553131104,"id":"https://metadata.un.org/sdg/1"}],"sustainable_development_goals_aurora":[{"display_name":"No poverty","score":0.550000011920929,"id":"https://metadata.un.org/sdg/1"}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W4315650970","https://openalex.org/W2118847041","https://openalex.org/W2024025088","https://openalex.org/W2126475390","https://openalex.org/W2016483411","https://openalex.org/W2403534611","https://openalex.org/W2167134322","https://openalex.org/W2419315711","https://openalex.org/W4391605618","https://openalex.org/W2136790891"],"abstract_inverted_index":{"OBJECTIVE:":[0],"The":[1,127],"prevalence":[2,28],"of":[3,29,32,54,59,96,111,124,129,143,147],"adverse":[4],"childhood":[5],"experiences":[6],"(ACEs)":[7],"increased":[8],"during":[9,35],"the":[10,27,41,50,57,94,139],"COVID-19":[11],"pandemic,":[12],"but":[13],"rural-urban":[14,24,47,91],"differences":[15,48,82,92],"have":[16],"not":[17],"yet":[18],"been":[19],"analyzed.":[20,67],"This":[21],"study":[22,131],"examines":[23],"disparities":[25],"in":[26,49,93,135,141,154],"and":[30,52,56,152],"predictors":[31],"experiencing":[33,112],"ACEs":[34,55,65,116],"COVID-19.":[36],"METHODS:":[37],"Using":[38],"data":[39],"from":[40],"2021-2022":[42],"National":[43],"Health":[44],"Interview":[45],"Survey,":[46],"type":[51],"number":[53],"odds":[58,95,110],"having":[60,97],"experienced":[61],"four":[62,98,113],"or":[63,99,114],"more":[64,72,100,115],"were":[66,71,79,89],"FINDINGS:":[68],"Rural":[69],"children":[70,151,153],"likely":[73],"to":[74],"experience":[75],"most":[76],"ACEs;":[77],"there":[78,88],"no":[80,90],"significant":[81],"for":[83,145],"racial":[84],"discrimination.":[85],"After":[86],"adjustment,":[87],"ACEs.":[101],"Children":[102],"with":[103,119],"a":[104,120],"lower":[105],"household":[106],"income":[107],"had":[108],"greater":[109],"than":[117],"those":[118],"higher":[121],"income,":[122],"regardless":[123],"rurality.":[125],"CONCLUSIONS:":[126],"findings":[128],"this":[130],"may":[132],"be":[133],"helpful":[134],"guiding":[136],"stakeholders":[137],"considering":[138],"populations":[140],"need":[142],"resources":[144],"impacts":[146],"ACEs,":[148],"particularly":[149],"rural":[150],"poverty.":[155]},"counts_by_year":[{"year":2025,"cited_by_count":1}],"updated_date":"2026-09-26T08:19:03.415552","created_date":"2025-10-10T00:00:00"}
