Adverse Childhood Experiences and Physical and Mental Health of Adults: Assessing the Mediating Role of Cumulative Life Course Poverty.

Abstract

Research has linked adverse childhood experiences (ACEs) to a host of negative health outcomes in adulthood. However, most existing studies focused on traumatic ACEs and used samples collected from a specific geographic unit (e.g., region, city, or state). This study examines the association between non-traumatic ACEs and health outcomes (i.e., self-rated health and psychological well-being) in adulthood, and assesses the extent to which the cumulative life course poverty accounts for these associations between ACEs and health. Public and de-identified data from Panel Study of Income Dynamics (PSID) (1968-2013) and its Childhood Retrospective Circumstances Study (CRCS) (2014) (N = 7,126) were used. Episode and severity of childhood adversities of respondents were determined by using comprehensive retrospective circumstance measures. Multivariate regression models were used to analyze the associations between ACEs and adult health. Mediation analysis was employed to assess the extent to which the associations were explained by cumulative life course poverty. Data analysis was carried out in 2019 using STATA 15. We found that episode and severity of ACEs were associated with increased risk of poor health and psychological distress. Compared to individuals with no ACEs, one unit increase in the ACE index is associated with 8 and 18 percent increase in the risk of poor health and psychological distress, respectively. A small proportion (4%) of the impact of early adversities on health is attributable to the proportion of adult lifetime spent in poverty. Non-traumatic ACEs are associated with increased risk for poor health and psychological distress. Life course cumulative experience in poverty accounts for a small portion of the associations. Providing support to prevent ACEs may have long-term health benefits.