Complex relationship of adverse childhood experiences with adult health outcomes

This chapter addresses whether adverse childhood experiences (ACEs) demonstrate disproportional prevalence across demographic- and health-affecting characteristics, offer significant explanation of adult health outcomes, and show patterned association with illness susceptibility early within and across adulthood when viewed in combination with income and psychosocial resources. Data were derived from a population-based state health survey using stratified random sampling of household adults (n=7,470): ages 18- 99 (M=55), 59.9% females, and race/ethnicity, income and education levels representative of the region. In addition to sociodemographics, we assessed ACEs by aggregating 8 adversity forms, and also assessed 5 health behaviors, 3 psychosocial resources, and 2 health outcomes (number of chronic conditions, subjective wellness). Disproportionality was evident in ACEs levels by demographics, adult SES, health behaviors and psychosocial resources in expected directions. Stepped multiple regressions of health outcomes demonstrated significant betas and R2 change for each predictor block, revealing cumulative as well as unique explanatory utility. Early onset of chronic illness was evident on the basis of ACEs levels. These illnesses were amplified for low income respondents. Prevalence was highest across adulthood for those also reporting low psychosocial resources. Findings offer novel insights as to the ?long reach? of childhood adversity on health, conditioned by circumstances under which these effects may occur. Health resilience offered by health behaviors and psychosocial resources should shape thinking about preventive and remedial interventions by social work and allied professionals across a range of settings.