The "long arm" of adverse childhood experiences on adult health depreciation in China

Qiuyan Fan; Hao Chen

doi:10.1016/j.chiabu.2023.106234

The "long arm" of adverse childhood experiences on adult health depreciation in China

Child Abuse Negl. 2023 Sep:143:106234. doi: 10.1016/j.chiabu.2023.106234. Epub 2023 May 25.

Authors

Qiuyan Fan¹, Hao Chen²

Affiliations

¹ Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan 430072, China. Electronic address: fanqiuyan@whu.edu.cn.
² Center for Social Security Studies of Wuhan University, Wuhan University, No. 299, Bayi Road, Wuchang District, Wuhan, Hubei 430072, China. Electronic address: chenhao-whucsss@whu.edu.cn.

PMID: 37244079
DOI: 10.1016/j.chiabu.2023.106234

Abstract

Background: The effects of childhood adversity on health may persist into the middle and old-aged. The assessment of the long-term effect of adverse childhood experiences (ACE) on adult health depreciation promotes a paradigm shift from current factors in health to early causation shaping health life course trajectories.

Objective: Determine whether the direct and significant dose-response effect between childhood adversity and health depreciation holds true, and to examine whether socioeconomic status (SES) in adulthood can diminish the negative effects of ACE.

Methods: A sample of 6344 nationally representative respondents (48 % were male; M_age = 64.48 years old, SD = 9.6 years old) was obtained. Adverse childhood experiences were collected from a Life History survey in China. Health depreciation was assessed by years lived with disabilities (YLDs) based on the Global Burden of Disease (GBD) disability weights. Ordinary least squares and matching methods (propensity score matching and coarsened exact matching) were used to test the relationship and treatment effect between ACEs and health depreciation. Mediating effect coefficients test and the Karlson-Holm-Breen (KHB) examined the mediating effect of socioeconomic status in adulthood.

Results: Compared to respondents without ACE, respondents who experienced 1 ACE increased YLD 15.9 % (p < 0.01); 2 ACEs by 32.8 % (p < 0.01); 3 ACEs by 47.4 % (p < 0.01), and 4+ ACEs by 71.5 % (p < 0.01) higher YLDs. The mediating effect of SES in adulthood was only between 3.9 % and 8.2 %. The interaction effect between ACE and adult socioeconomic status was not significant.

Conclusion: The "long arm" of ACE on health depreciation exhibited a significant dose-response relationship. Policies and measures aimed at reducing family dysfunction and strengthening early childhood health interventions can facilitate the reduction of health depreciation in middle and old age.

Keywords: Adverse childhood experiences; Health depreciation; Long-term health effects.

MeSH terms

Adult
Adverse Childhood Experiences*
Aged
Child
Child, Preschool
China / epidemiology
Depreciation
Female
Humans
Life Change Events
Male
Middle Aged
Surveys and Questionnaires