Award Date


Degree Type


Degree Name

Doctor of Philosophy (PhD)


Environmental and Occupational Health

First Committee Member

Michelle Chino

Second Committee Member

Jay Shen

Third Committee Member

Guogen Shan

Fourth Committee Member

Denby-Brinson Ramona

Number of Pages



The objective of this study is to examine the association between adverse childhood experiences (ACEs) in the context of family and community and the likelihood of subsequent unintentional and intentional, nonfatal injury in young adulthood (ages 24-32 years). Using a cross sectional study design, data from Waves I and IV of the National Longitudinal Study of Adolescent and Adult Health, a nationally representative sample (n = 14,800) was used to examine the relationship between 16 types of ACEs and a cumulative ACE score and the odds of seven injury outcomes in young adulthood. Over a third (37.6%) of young adults sustained at least one of the seven injury outcomes. Most (93.4%) participants endorsed at least one ACE type with a mean ACE score of 2.99 (SE, 0.26). Overall, child maltreatment, particularly physical abuse and emotional neglect, tended to have a strong influence on the odds of both unintentional and intentional injury (p < .05). Interpersonal loss, such as a family member or friend’s suicide attempt or experiencing the death of a parent tended to have a strong influence on the odds of intentional injuries (p < .05). With the exception of suicide attempt, we found a significant graded relationship between the number of ACE exposures and injury. For every additional ACE endorsed, the odds of injury were: Serious Injury (odds ratio (OR): 1.16), Motor Vehicle Accident (OR: 1.09), Physical IPV (OR: 1.13), Sexual IPV (OR: 1.22), Shot/Stabbed (OR: 1.16), Beaten Up (OR: 1.25). This study suggests that exposure to ACEs in childhood and adolescence are risk factors that increase the odds of subsequent injury in young adulthood.


ACEs; Child Maltreatment and Abuse; Community Violence; Household dysfunction; Intentional Injury; Unintentional Injury


Public Health

File Format


Degree Grantor

University of Nevada, Las Vegas




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