Specific domains of positive childhood experiences (PCEs) associated with improved adult health: A nationally representative study

Jaime La Charite; Mariam Khan; Rebecca Dudovitz; Teryl Nuckols; Narayan Sastry; Cher Huang; Yvonne Lei; Adam Schickedanz

doi:10.1016/j.ssmph.2023.101558

Specific domains of positive childhood experiences (PCEs) associated with improved adult health: A nationally representative study

SSM Popul Health. 2023 Nov 11:24:101558. doi: 10.1016/j.ssmph.2023.101558. eCollection 2023 Dec.

Authors

Jaime La Charite^{1

2}, Mariam Khan^{3

4}, Rebecca Dudovitz⁵, Teryl Nuckols⁶, Narayan Sastry⁷, Cher Huang⁸, Yvonne Lei³, Adam Schickedanz⁵

Affiliations

¹ Department of General Internal Medicine, University of California, Los Angeles, 1100 Glendon Ave. Suite 900, Los Angeles, CA, 90024, USA.
² Cedars-Sinai Medical Center, Los Angeles, California, USA.
³ David Geffen School of Medicine at University of California, 10833 Le Conte Ave., Los Angeles, CA, 90095, USA.
⁴ Fielding School of Public Health at University of California, 650 Charles E Young Drive, Los Angeles, CA, 90095, USA.
⁵ Department of Pediatrics, University of California, Los Angeles, California, 10833 LeConte Ave., 12-358 CHS, Los Angeles, California, 90095, USA.
⁶ Division of General Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, California, 8700 Beverly Blvd Ste 113 Los Angeles, California, 90048, USA.
⁷ Institute for Social Research, University of Michigan, 426 Thompson St, Ann Arbor, MI, 48104, USA.
⁸ Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA.

Abstract

Background: Positive childhood experiences (PCEs) are supportive relationships and environments associated with improved health when aggregated into composite scores. Adverse childhood experiences (ACEs), a reciprocal measure to PCEs, are associated with worse health in aggregate scores and when disaggregated into measures of specific ACE types (hereafter domains). Understanding the associations between specific PCE domains and health, while accounting for ACEs, may direct investigations and intervention planning to foster PCE exposure.

Methods: We analyzed data from the nationally representative United States longitudinal Panel Study of Income Dynamics. Five PCE domains were examined: (i) peer support and healthy school climate, (ii) neighborhood safety, (iii) neighborhood support, and nurturing relationships with (iv) maternal and (v) paternal figures. Survey weighted logistic regression models tested associations between each PCE domain measure and adult general health rating, controlling for demographic covariates and nine ACE exposures: physical, emotional, or sexual abuse/assault; emotional neglect; witnessing intimate partner violence or household substance use; having a parent with mental illness; any parental separation or divorce; and/or having a deceased or estranged parent. Secondary outcomes included adult functional status and mental and physical health diagnoses. We also tested for statistical interactions between PCE domain and ACE score measures.

Results: The sample included 7105 adults. Higher scores for the "peer support and healthy school climate" and "neighborhood safety" domain measures showed the most protective relationships with the adverse health conditions tested, most notably for mental illness. The relationship between PCE domain measures and health outcomes was attenuated, but not statistically moderated by ACE exposure.

Conclusion: Experiencing childhood peer support, a healthy school climate, and neighborhood safety were especially protective against multiple adult health conditions, including for ACE exposed individuals. Interventions that promote PCEs may yield population health gains.

Keywords: Adverse childhood experiences; Mental health; Neighborhood; Positive childhood experiences; School; Self-rated health.

Grants and funding

K23 HD099308/HD/NICHD NIH HHS/United States