Adverse Childhood Experience Patterns Tied to Premature Death

Family Instability, Poverty & Crowded Housing, and Poverty & Parental Separation clusters linked to increased risk

WEDNESDAY, Sept. 7, 2022 (HealthDay News) — Adverse childhood experiences (ACEs) can be clustered into patterns, and some of these patterns are associated with an increased risk for premature mortality in adulthood, according to a study published online Aug. 23 in The Lancet Regional Health: Americas.

Jing Yu, Ph.D., from the Eunice Kennedy Shriver National Institute of Child Health and Human Development in Bethesda, Maryland, and colleagues examined how the cumulative number and clustering patterns of ACEs are related to premature mortality among 46,129 offspring (born in 1959 to 1966) of participants enrolled in the Collaborative Perinatal Project (CPP).

The researchers found that during the 38-year follow-up through 2016, 3,344 deaths occurred among the CPP offspring. There were five latent classes of ACEs. Children in the Family Instability, Poverty & Crowded Housing, and Poverty & Parental Separation classes had an increased risk for premature mortality compared with children with Low Adversity (hazard ratios [HRs], 1.28, 1.41, and 1.50, respectively). Compared with children with none, children with two (HR, 1.27), three (HR, 1.29), and four or more ACEs (HR, 1.45) also had an increased risk for mortality. The Poverty & Crowded Housing and Poverty & Parental Separation clusters remained associated with an increased risk for premature mortality beyond the cumulative risk associated with a higher number of ACEs (HRs, 1.28 and 1.23, respectively, versus 1.05).

“There is a strong basis for considering the patterns of ACEs to which children are exposed in order to identify children at greatest risk, to better understand life course mechanisms, and to improve prevention and interventions,” the authors write.