BackgroundAdverse childhood experiences (ACEs) including child abuse and household problems (e.g. domestic violence) increase risks of poor health and mental well-being in adulthood. Factors such as having access to a trusted adult as a child may impart resilience against developing such negative outcomes. How much childhood adversity is mitigated by such resilience is poorly quantified. Here we test if access to a trusted adult in childhood is associated with reduced impacts of ACEs on adoption of health-harming behaviours and lower mental well-being in adults.MethodsCross-sectional, face-to-face household surveys (aged 18–69 years, February-September 2015) examining ACEs suffered, always available adult (AAA) support from someone you trust in childhood and current diet, smoking, alcohol consumption and mental well-being were undertaken in four UK regions. Sampling used stratified random probability methods (n = 7,047). Analyses used chi squared, binary and multinomial logistic regression.ResultsAdult prevalence of poor diet, daily smoking and heavier alcohol consumption increased with ACE count and decreased with AAA support in childhood. Prevalence of having any two such behaviours increased from 1.8% (0 ACEs, AAA support, most affluent quintile of residence) to 21.5% (≥4 ACEs, lacking AAA support, most deprived quintile). However, the increase was reduced to 7.1% with AAA support (≥4 ACEs, most deprived quintile). Lower mental well-being was 3.27 (95% CIs, 2.16–4.96) times more likely with ≥4 ACEs and AAA support from someone you trust in childhood (vs. 0 ACE, with AAA support) increasing to 8.32 (95% CIs, 6.53–10.61) times more likely with ≥4 ACEs but without AAA support in childhood. Multiple health-harming behaviours combined with lower mental well-being rose dramatically with ACE count and lack of AAA support in childhood (adjusted odds ratio 32.01, 95% CIs 18.31–55.98, ≥4 ACEs, without AAA support vs. 0 ACEs, with AAA support).ConclusionsAdverse childhood experiences negatively impact mental and physical health across the life-course. Such impacts may be substantively mitigated by always having support from an adult you trust in childhood. Developing resilience in children as well as reducing childhood adversity are critical if low mental well-being, health-harming behaviours and their combined contribution to non-communicable disease are to be reduced.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-017-1260-z) contains supplementary material, which is available to authorized users.

ObjectivesThe lifelong health impacts of adverse childhood experiences are increasingly being identified, including earlier and more frequent development of non-communicable disease. Our aim was to examine whether adverse childhood experiences are related to increased use of primary, emergency and in-patient care and at what ages such impact is apparent.MethodsHousehold surveys were undertaken in 2015 with 7414 adults resident in Wales and England using random probability stratified sampling (age range 18–69 years). Nine adverse childhood experiences (covering childhood abuse and household stressors) and three types of health care use in the last 12 months were assessed: number of general practice (GP) visits, emergency department (ED) attendances and nights spent in hospital.ResultsLevels of use increased with increasing numbers of adverse childhood experiences experienced. Compared to those with no adverse childhood experiences, odds (±95% CIs) of frequent GP use (≥6 visits), any ED attendance or any overnight hospital stay were 2.34 (1.88–2.92), 2.32 (1.90–2.83) and 2.67 (2.06–3.47) in those with ≥ 4 adverse childhood experiences. Differences were independent of socio-economic measures of deprivation and other demographics. Higher health care use in those with ≥ 4 adverse childhood experiences (compared with no adverse childhood experiences) was evident at 18–29 years of age and continued through to 50–59 years. Demographically adjusted means for ED attendance rose from 12.2% of 18-29 year olds with no adverse childhood experiences to 28.8% of those with ≥ 4 adverse childhood experiences. At 60–69 years, only overnight hospital stay was significant (9.8% vs. 25.0%).ConclusionsAlong with the acute impacts of adverse childhood experiences on child health, a life course perspective provides a compelling case for investing in safe and nurturing childhoods. Disproportionate health expenditure in later life might be reduced through childhood interventions to prevent adverse childhood experiences.

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ObjectiveTo examine factors associated with suffering harm from another person's alcohol consumption and explore how suffering such harms relate to feelings of safety in nightlife.DesignCross-sectional opportunistic survey (Global Drug Survey) using an online anonymous questionnaire in 11 languages promoted through newspapers, magazines and social media.SubjectsIndividuals (participating November 2014–January 2015) aged 18–34 years, reporting alcohol consumption in the past 12 months and resident in a country providing ≥250 respondents (n=21 countries; 63 725 respondents).Main outcome measuresHarms suffered due to others’ drinking in the past 12 months, feelings of safety on nights out (on the way out, in bars/pubs, in nightclubs and when travelling home) and knowledge of over-serving laws and their implementation.ResultsIn the past 12 months, >40% of respondents suffered at least one aggressive (physical, verbal or sexual assault) harm and 59.5% any harm caused by someone drunk. Suffering each category of harm was higher in younger respondents and those with more harmful alcohol consumption patterns. Men were more likely than women to have suffered physical assault (9.2% vs 4.7; p<0.001), with women much more likely to suffer sexual assault or harassment (15.3% vs 2.5%; p<0.001). Women were more likely to feel unsafe in all nightlife settings, with 40.8% typically feeling unsafe on the way home. In all settings, feeling unsafe increased with experiencing more categories of aggressive harm by a drunk person. Only 25.7% of respondents resident in countries with restrictions on selling alcohol to drunks knew about such laws and 75.8% believed that drunks usually get served alcohol.ConclusionsHarms from others’ drinking are a threat to people's health and well-being. Public health bodies must ensure that such harms are reflected in measures of the societal costs of alcohol, and must advocate for the enforcement of legislation designed to reduce such harms.

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