Vital Signs: Estimated Proportion of Adult Health Problems Attributable to Adverse Childhood Experiences and Implications for Prevention — 25 States, 2015–2017

Summary & key facts

Researchers used a large state health survey from 25 states collected from 2015 to 2017 to see how bad experiences in childhood are linked to adult health, behaviors, and life outcomes. They found that adults who had more types of adverse childhood experiences were more likely to report things like heart disease, lung disease, diabetes, depression, heavy drinking, smoking, lower education, unemployment, and no health insurance. About one in six adults in the study reported four or more types of childhood adversity. The authors estimated that, if those childhood harms were prevented, some adult problems might fall a lot — for example depression cases could be nearly halved in this group — but the study cannot prove cause and it used self-reported data from only 25 states.

Key facts:

• The study used state health survey answers from 25 states collected between 2015 and 2017 to look at adult health and life outcomes linked to childhood adversity.
• About 1 in 6 adults in the study reported four or more types of adverse childhood experiences.
• People with more childhood adversity were more likely to report many adult problems including heart disease, stroke, asthma, chronic lung disease, cancer, kidney disease, diabetes, and depression.
• Childhood adversity was also linked to higher rates of current smoking and heavy drinking, lower chances of finishing high school, unemployment, and lacking health insurance.
• The researchers estimated how much each adult problem might fall if adverse childhood experiences were prevented. The estimated reductions ranged from a few percent for overweight to nearly half for depression.
• Some headline estimates were that depression might fall by about 44 percent, chronic lung disease by about 27 percent, and heavy drinking by about 24 percent if those childhood harms were prevented in this population.
• The study used statistical methods that adjusted for age, race or ethnicity, and sex, and it relied on people’s own reports, so it shows strong links but does not prove that childhood adversity directly caused the adult problems.

Abstract

INTRODUCTION: Adverse childhood experiences, such as violence victimization, substance misuse in the household, or witnessing intimate partner violence, have been linked to leading causes of adult morbidity and mortality. Therefore, reducing adverse childhood experiences is critical to avoiding multiple negative health and socioeconomic outcomes in adulthood. METHODS: Behavioral Risk Factor Surveillance System data were collected from 25 states that included state-added adverse childhood experience items during 2015-2017. Outcomes were self-reported status for coronary heart disease, stroke, asthma, chronic obstructive pulmonary disease, cancer (excluding skin cancer), kidney disease, diabetes, depression, overweight or obesity, current smoking, heavy drinking, less than high school completion, unemployment, and lack of health insurance. Logistic regression modeling adjusting for age group, race/ethnicity, and sex was used to calculate population attributable fractions representing the potential reduction in outcomes associated with preventing adverse childhood experiences. RESULTS: Nearly one in six adults in the study population (15.6%) reported four or more types of adverse childhood experiences. Adverse childhood experiences were significantly associated with poorer health outcomes, health risk behaviors, and socioeconomic challenges. Potential percentage reductions in the number of observed cases as indicated by population attributable fractions ranged from 1.7% for overweight or obesity to 23.9% for heavy drinking, 27.0% for chronic obstructive pulmonary disease, and 44.1% for depression. CONCLUSIONS AND IMPLICATIONS FOR PUBLIC HEALTH PRACTICE: Efforts that prevent adverse childhood experiences could also potentially prevent adult chronic conditions, depression, health risk behaviors, and negative socioeconomic outcomes. States can use comprehensive public health approaches derived from the best available evidence to prevent childhood adversity before it begins. By creating the conditions for healthy communities and focusing on primary prevention, it is possible to reduce risk for adverse childhood experiences while also mitigating consequences for those already affected by these experiences.

Topics

Child Abuse and Related Trauma Child Abuse and Trauma Gun Ownership and Violence Research

Categories

Clinical Psychology Psychology Social Sciences

Tags

Adverse effect Behavioral Risk Factor Surveillance System Demography Environmental health Gerontology Internal medicine Medicine Obesity Overweight Pathology Pediatrics Population Public health Socioeconomic status Sociology

Conditions & symptoms

Depression Substance abuse disorder Addiction or harmful habbits Sadness or low mood