Although adverse childhood events have been linked to leading causes of adult morbidity and mortality in many studies over recent decades, the Centers for Disease Control and Prevention (CDC) has released a new analysis of childhood experiences and their effect on adult outcomes.
Adverse childhood experiences were defined in the analysis as exposure to violence in childhood (e.g. physical, sexual, or psychological violence) or witnessing potentially traumatic experiences in the home (e.g. intimate partner violence, mental illness, or substance misuse).
Many previous studies have found that adverse childhood experiences are linked to increased risks for alcohol and substance abuse disorders, suicide, mental health conditions, heart disease, other chronic illnesses, and health risk behaviors throughout life. Adverse experiences during childhood have also been linked to reduced educational attainment, employment, and income, which all affect health and well-being both directly and indirectly, according to the study.
Using responses from the Behavioral Risk Factor Surveillance System (BRDSS), data were collected from 144,017 respondents who answered questions regarding adverse childhood experiences and provided responses for age, race/ethnicity, and sex. The researchers found that 60.9% of adults in the study population experienced at least 1 type of adverse childhood event, whereas 15.6% experienced 4 or more types.
Overall, adults with the highest levels of adverse childhood experience exposures had higher odds of having chronic health conditions. Similarly, the chances of being a current smoker, heavy drinker, and experiencing socioeconomic challenges including current unemployment were all higher among adults with higher levels of adverse childhood experience exposure, according to the study.
More specifically, the analysis noted that women, respondents who identify as American Indian or Alaskan Native (AI/AN), black respondents, and those who selected the "Other" racial/ethnic group were more likely to experience 4 or more types of adverse childhood experiences.
The study also found that younger groups had higher reported rates of adverse childhood experiences, although this difference could be attributed to differences across cohorts in risk, willingness to disclose, or ability to recall childhood experiences. Increased mortality among those with higher adverse childhood experiences could also contribute to the difference, the study authors noted.
Preventing childhood adverse experiences could significantly reduce risks of developing chronic health and socioeconomic conditions. The estimated overall percentage reductions in chronic health conditions associated with preventing all adverse childhood experiences ranged from 1.7% for overweight or obesity and reached as high as 27% for chronic obstructive pulmonary disease. Significant reductions in risk were also noted for depression (44.1%), current smoking (32.9%), and heavy drinking (23.9%).
The authors recommended several ways that communities could reduce childhood adverse experiences. For more at-risk populations (women, AI/AN, black, and "Other" respondents), the authors recommended that communities focus on reducing stressors that these groups face from living in under-resourced neighborhoods as well as historical and ongoing trauma due to systemic racism or multigenerational poverty.
They also noted that prevention of adverse childhood experiences is possible with state and local efforts to strengthen families and communities, provide parental support, and increase access to comprehensive health services.
Merrick M, Ford D, Ports K, Guinn A, et al. Vital Signs: Estimated Proportion of Adult Health Problems Attributable to Adverse Childhood Experiences and Implications for Prevention - 25 States, 2015-2017. CDC website.https://www.cdc.gov/mmwr/volumes/68/wr/mm6844e1.htm?s_cid=mm6844e1_w. Accessed November 7, 2019.