Childhood adversity associated with poorer health: Evidence from the U.S. National Survey of Children's Health

Benjamin H Walker; Dustin C Brown; Courtney S Walker; Megan Stubbs-Richardson; Arazais D Oliveros; Susan Buttross

doi:10.1016/j.chiabu.2022.105871

Childhood adversity associated with poorer health: Evidence from the U.S. National Survey of Children's Health

Child Abuse Negl. 2022 Dec:134:105871. doi: 10.1016/j.chiabu.2022.105871. Epub 2022 Sep 9.

Authors

Benjamin H Walker¹, Dustin C Brown², Courtney S Walker³, Megan Stubbs-Richardson⁴, Arazais D Oliveros⁵, Susan Buttross⁶

Affiliations

¹ Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39212, United States of America. Electronic address: bwalker5@umc.edu.
² Department of Sociology, Mississippi State University, Bowen Hall, 456 Hardy Road, Mississippi State, MS 39762, United States of America; Social Science Research Center, Mississippi State University, 1 Research Blvd, Suite 103, Starkville, MS 39759, United States of America.
³ Department of Psychiatry, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39212, United States of America.
⁴ Social Science Research Center, Mississippi State University, 1 Research Blvd, Suite 103, Starkville, MS 39759, United States of America.
⁵ Department of Psychology, Mississippi State University, PO Box 6161, 202 Magruder Hall, Mississippi State, MS 39762, United States of America.
⁶ Department of Pediatrics, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39212, United States of America.

PMID: 36095924
DOI: 10.1016/j.chiabu.2022.105871

Abstract

Background: The association between adverse childhood experiences (ACEs) and increased risk of health problems is well established. However, many studies have relied on unrepresentative or high-risk samples and have focused on a narrow range of health problems. Prior research assessing potential age differences in the ACE-health connection is also sparse.

Objective: To comprehensively examine the extent to which ACEs are associated with physical, mental, and neurodevelopmental health outcomes in childhood and assess whether these associations differ between age groups.

Participants & setting: Pooled cross-sectional data from the 2016-2019 National Survey of Children's Health (N = 98,732).

Methods: We estimated age-stratified binary logistic regression models examining associations between the number of ACEs and physical, mental, and neurodevelopmental health problems net of sociodemographic and socioeconomic controls. Separate models were estimated for the total population (ages 3-17), early childhood (ages 3-5), middle childhood (ages 6-11), and adolescence (ages 12-17).

Results: We observed a dose-response relationship between ACE exposure and childhood physical, mental, and neurodevelopmental health problems in all age groups. The largest disparities exist between children with no ACEs and three or more ACEs. Compared to children without ACEs, children with three or more ACEs had significantly higher adjusted odds of externalizing disorders (OR = 4.40), internalizing disorders (OR = 5.13), neurodevelopmental disorders (OR = 2.40), and physical health problems (OR = 2.08).

Conclusions: Our results add to evidence linking ACEs to childhood health disparities. Further, findings indicate that ACEs have persistent negative effects across age groups and that clinicians should monitor ACEs when assessing children's physical, mental, and neurodevelopmental health at any age.

Keywords: Adverse childhood experiences; Child development; Medicine; Mental health; Pediatrics.

MeSH terms

Adolescent
Adverse Childhood Experiences*
Child
Child Health
Child of Impaired Parents* / psychology
Child, Preschool
Cross-Sectional Studies
Humans
Neurodevelopmental Disorders*