Adverse childhood experiences and lifelong health

Bhutta, Zulfiqar A; Bhavnani, Supriya; Betancourt, Theresa S.; Tomlinson, Mark; Patel, Vikram

doi:10.1038/s41591-023-02426-0

Cited by 40 publications

(22 citation statements)

References 82 publications

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“…45 The review also highlighted the role of toxic stress in childhood in disrupting the body's stress response system, leading to long-term physiological dysregulation and inflammation, which, in turn, contributes to increased health risks in older individuals. A study by Bhutta et al 46 demonstrated how toxic stress in childhood can lead to persistent inflammation and immune dysregulation, predisposing individuals to chronic diseases later in life. These mechanisms have been well-documented in several studies, supporting the conclusions drawn in this systematic review.…”

Section: Discussionmentioning

confidence: 99%

The long‐term effects of childhood circumstances on older individuals: A systematic review

Parvin,

Johra,

Akter

et al. 2024

Aging Medicine

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Childhood experiences are known to shape individuals' development and can influence various aspects of life later on. Understanding the long‐term effects is crucial for informing interventions and policies aimed at promoting healthy aging. This review aimed to explore the long‐term effects of childhood experiences on older individuals. This systematic review comprised three distinct phases. Firstly, a systematic review was conducted, exploring databases such as Google Scholar, PubMed, EMBASE, PsycINFO, and the Web of Science. Out of the 2116 studies initially identified, 24 studies were selected based on the inclusion criteria. Secondly, these inclusion criteria were applied to ensure that the chosen studies specifically delved into the connection between childhood experiences and outcomes in older individuals. Finally, data extraction and synthesis techniques were employed to analyze findings, facilitating the drawing of conclusions concerning the enduring impacts of childhood experiences on the well‐being of older individuals. The review's findings revealed how negative experiences in childhood continue to affect older individuals in various ways. These early‐life events have far‐reaching consequences, profoundly impacting their physical health, making them more susceptible to chronic diseases and weakening their immune system. Additionally, they affect mental health, leading to conditions like depression, anxiety, and substance abuse. Cognitive function is also affected, resulting in memory problems and cognitive decline. Furthermore, these experiences impact social relationships, affecting trust, emotional control, and social isolation in later life. This review highlighted the enduring influence of childhood circumstances on the health and well‐being of older individuals. Policymakers and health care practitioners should consider these findings when developing strategies to support healthy aging and mitigate the long‐term effects of adverse childhood experiences.

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Section: Discussionmentioning

confidence: 99%

The long‐term effects of childhood circumstances on older individuals: A systematic review

Parvin,

Johra,

Akter

et al. 2024

Aging Medicine

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“…Prevalence of orphanhood and grandparent caregiver death from all causes B 0 1 2 3 4 2 0 0 0 2 0 0 1 2 0 0 2 2 0 0 3 2 0 0 4 2 0 0 5 2 0 0 6 2 0 0 7 2 0 0 8 2 0 0 9 2 0 1 0 2 0 1 1 2 0 1 2 2 0 1 3 2 0 1 4 2 0 1 5 2 0 1 6 2 0 1 7 2 0 1 8 2 0 1 9 2 0 2 0 2 0 2 1 431 (358,301, 360,531) 406,733 (405,437, 407,928) +39.5% (+38.8%, +40.1%) +55.5% (+54.7%, +56.3%) Ages 0-4 years 45,358 (45,113, 45,599) 53,918 (53,680, 54,175) +18.9% (+18.1%, +19.7%) 65,918 (65,635, 66,198) 72,959 (72,651, 73,234) 1,360,301 (1,357,973, 1,362,583) 1,318,925 (1,317,104, 1,320,941) -3.0 (-3.2, -2.8) 1,351,530 (1,349,757,1,353,610) Supplementary Table S6: Race & ethnicity groups most affected by the leading caregiver loss cause-of-death in the ten U.S. states with highest orphanhood prevalence rates in 2021 (continued).…”

Section: Figures and Tablesmentioning

confidence: 99%

“…Deaths of parents and co-residing/custodial grandparent caregivers, in the context of intersecting social and health crises, threaten child wellbeing 1 due to losses of nurturance, financial support, housing, and care. 2–4 Orphanhood (death of one or both parents) 5,6 and caregiver loss (death of co-resident/custodial grandparents) are considered Adverse Childhood Experiences (ACEs), 7,8 and may have enduring consequences that persist well into adulthood.…”

Section: Introductionmentioning

confidence: 99%

Orphanhood and caregiver death among children in the United States due to all-cause mortality 2000-2021: A Modeling Study

Villaveces,

Chen,

Tucker

et al. 2024

Preprint

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Importance: Deaths of parents and grandparent caregivers linked to social and health crises threaten child wellbeing due to losses of nurturance, financial support, physical safety, family stability, and care. Little is known about the full burden of all-causes and leading cause-specific orphanhood and caregiver death beyond estimates from select causes. Objective: To estimate 2000-2021 prevalence and incidence trends of all-cause orphanhood and caregiver death among children <18, by cause, age, race/ethnicity, and state. Data Sources: National Center for Health Statistics (NCHS) birth, death, race/ethnicity, and population data to estimate fertility rates and identify causes of death; 1983-1998 ICD-9 causes-of-death harmonized to ICD-10 classifications; 1999-2021 ICD-10 causes-of-death; CDC WONDER for state-specific estimates; and American Community Survey for grandparent population estimates. Data extraction and synthesis: We extracted U.S. population-level death, birth, population size, race, and ethnicity data from NCHS and attributed to each deceased individual the average number of children left behind according to subgroup-specific fertility rates in the previous 0-17 years. We examined prevalence and incidence of orphanhood by leading causes-of-death, including COVID-19, the leading 5 causes-of-death for 1983-2021, and additional leading causes for ages 15-44. We extended these to obtain state-level outcome estimates. Main outcome measures: National incidence and prevalence of orphanhood and caregiver death from 2000-2021, with orphanhood by year, parental cause-of-death and sex, child age, race/ethnicity, and state. Results: From 2000-2021, orphanhood and custodial/co-residing grandparent caregiver loss annual incidence and prevalence trends increased 49.2% and 8.3%, respectively. By 2021, 2.9 million children (4% of all children) had experienced prevalent orphanhood and caregiver death. Populations disproportionately affected by orphanhood included 5.0% of all adolescents; 6.5%, 4.8%, and 3.9% respectively of non-Hispanic American Indian/Alaska Native, non-Hispanic Black, and non-Hispanic White children; and children in New Mexico and Southern and Eastern States. Parental death due to drug overdose during 2020-2021 surpassed COVID-19 as the leading cause of incident and prevalent orphanhood during the COVID-19 pandemic. Conclusions and Relevance: Policies, programs, and practices aimed at orphanhood prevention, identification, and linkage to services and support of nearly 3 million bereaved children are needed, foremost prioritizing rapidly increasing overdose-linked orphanhood.

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“…In a sample of US adolescents, McLaughlin et al (2012) estimated that population-attributable risk proportions for a set of 12 ACEs ranged from 15.7% for fear disorders to 40.7% for behaviour disorders. As such, childhood adversity represents a profound social determinant of mental health that requires urgent action and attention in terms of both prevention and intervention (Bhutta et al, 2023;Ceccarelli et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

Access to and perceived unmet need for mental health services and support in a community sample of UK adolescents with and without experience of childhood adversity

Soneson,

White,

Howarth

et al. 2024

Epidemiol Psychiatr Sci

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Aims Children and adolescents with a history of adverse childhood experiences (ACEs) are more likely than their peers to develop mental health difficulties, but not enough is known about their help-seeking behaviours and preferences. We aimed to determine whether ACEs are associated with access to and perceived unmet need for mental health services and support amongst secondary school students. Methods We used multi-level logistic regression with data from the 2020 OxWell Student Survey to assess whether ACEs were associated with (1) prior access to mental health support and (2) perceived unmet need for mental health services in a community sample of English secondary school students. We assessed ACEs as a cumulative score from the Center for Youth Wellness Adverse Childhood Experiences Questionnaire: Teen Self-Report version and accounted for current mental health difficulties as measured by the 25-item Revised Children’s Anxiety and Depression Scale (RCADS). Results Our analysis included 2018 students across 64 schools, of whom 29.9% (598/2002) reported prior access to mental health support. Of those not reporting prior access, 34.1% (469/1377) reported a perceived unmet need for services. In the unadjusted models, cumulative ACE scores were significantly positively associated with both prior access to mental health support (odds ratio (OR) = 1.36; 95% confidence interval (CI): 1.29–1.43) and perceived unmet need for mental health services (OR = 1.47; 95% CI: 1.37–1.59), meaning that students who had experienced adversity had a greater chance of having previously accessed support as well as perceiving an unmet need for services. After adjusting for mental health difficulties and other sociodemographic variables, cumulative ACE scores were positively associated with prior access (adjusted OR (aOR) = 1.25; 95% CI: 1.17–1.34 with a significant interaction between RCADS and ACE scores, aOR = 0.88; 95% CI: 0.84–0.93) as well as perceived unmet need (aOR = 1.32; 95% CI: 1.21–1.43 with a significant interaction between RCADS and ACE scores, aOR = 0.85; 95% CI: 0.78–0.91). Conclusions Although it is encouraging that adolescents with experience of adversity are more likely than their peers with similar levels of depression and anxiety symptoms to have accessed mental health support, there remains a concern that those who have not accessed support are more likely to perceive an as-yet unmet need for it. Mental health support must be available, accessible and acceptable to all who need it, especially for those groups that traditionally have not accessed services, including the more marginalised and vulnerable populations.

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Adverse childhood experiences and lifelong health

Cited by 40 publications

References 82 publications

The long‐term effects of childhood circumstances on older individuals: A systematic review

The long‐term effects of childhood circumstances on older individuals: A systematic review

Orphanhood and caregiver death among children in the United States due to all-cause mortality 2000-2021: A Modeling Study

Access to and perceived unmet need for mental health services and support in a community sample of UK adolescents with and without experience of childhood adversity

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