Adverse childhood experiences double the risk of premature death

Oct 6 2009

Many U.S. children face a terrible burden of stressors that can harm the development of their brains and nervous systems. These stressors can lead to health problems and diseases throughout their lives, ultimately causing some to die prematurely, according to the lead author of a new study.

David W. Brown., D.Sc., an epidemiologist at the Centers for Disease Control and Prevention (CDC), and colleagues found that children who were exposed to six or more "adverse childhood experiences" or ACEs were at double the risk of premature death compared to children who had not suffered these experiences.

On average, the children at highest risk eventually died at age 60, compared to low-risk children who lived to age 79.

The study appears in the November issue of the American Journal of Preventive Medicine.

Conducted by Kaiser Permanente in San Diego and the CDC, the study looked at the long-term effects of these childhood experiences: undergoing verbal or physical abuse, having a battered mother and witnessing domestic violence, living in a household with substance abuse or mental illness, having an incarcerated household member or having parents who separated or divorced.

Data came from 17,337 adults who visited Kaiser Permanente from 1995 to 1997 and completed a standardized medical questionnaire that included questions about their childhood. Researchers followed participants through the end of 2006, using the National Death Index to discover who had died.

"Overall, 1,539 people died during follow-up," Brown said. "People with six or more ACEs died nearly 20 years earlier on average than those without ACEs. It is also disturbing that two-thirds of study participants — persons who were relatively well off — had at least one of the ACEs."

"The database of the Adverse Childhood Experiences study, utilized in this issue by Dr. Brown and his colleagues to demonstrate the link between childhood adversity and premature death, may ultimately provide us with most important public health data ever compiled," said Sandra L. Bloom, M.D., an associate professor of health management and policy at Drexel University School of Public Health.

"Our hope is that, as a result of this research, child maltreatment and exposure to childhood traumatic stress in its various forms will be more widely recognized as a public health problem," Brown said. "It is important to understand that consequences to childhood trauma can extend over an individual's life."

Brown DW, et al. Adverse childhood experiences and the risk of premature mortality. Am J Prev Med 37(5), 2009.