Childhood neglect linked with mental and physical health problems in adulthood

New research from the University of Toronto found that childhood neglect, even in the absence of childhood sexual abuse and physical abuse, is linked with a wide range of mental and physical health problems in adulthood.

While a large body of research has established the detrimental impact of childhood physical and sexual abuse on adult health outcomes, much less is known about whether neglect, in the absence of abuse, has similar negative outcomes. Our research underlines the importance of health professionals documenting whether their patients have a history of neglect in addition to other childhood adversities."

Linxiao Zhang, first author, PhD student at the Factor-Inwentash Faculty of Social Work (FIFSW), University of Toronto

The researchers found significant associations between childhood neglect and numerous health problems in adults when controlling for age, sex and race. Examples of poor physical health included stroke, asthma, and COPD. Disabilities such as hearing impairment, vision impairment, cognitive impairment, and mobility issues were also linked with childhood neglect, as was poor mental health, such as depression.

The study, published this week in Child Abuse and Neglect, used a large representative sample of more than 41,000 American adults drawn from the 2021 Behavioral Risk Factor Surveillance Survey.

Having established a link between childhood neglect and a range of mental and physical health problems, the authors were interested in identifying factors that may promote resilience among those who have experienced neglect. Further research indicated that the relationship between child neglect and adverse health outcomes in adulthood was largely attenuated when controlling for two key factors: adult socioeconomic status and the presence of a supportive adult in childhood.

"It appears that neglected children who manage to remain in school longer and have a reasonable income in adulthood are considerably less vulnerable to health problems in later life than neglected children who are less educated and less financially secure in their adult years." said co-author Andie MacNeil, a PhD student at University of Toronto's FIFSW.

Unfortunately, remaining in school longer may can be a challenge for those experiencing neglect. Previous research has found childhood adversity to be associated with leaving school early and earning less in adulthood. In turn, poverty and lower levels of education are often associated with more mental and physical health conditions in adulthood.

Children who have a supportive adult in their lives are also more likely to overcome challenges associated with neglect.

"A protective adult is someone who made the child feel safe and protected in the home," said co-author Ishnaa Gulati, a recent Master of Public Health graduate of the Dalla Lana School of Public Health at the University of Toronto. "Our findings suggest that this nurturing role may provided critical support to children, even when they were lacking basic necessities."

The authors are hopeful that these findings can help support the well-being of survivors of childhood neglect.

"Although there are still significant health disparities between those with and without a history of neglect, our findings highlight potential ways forward to help promote better health outcomes among survivors of neglect," said senior author Esme Fuller-Thomson, a Professor at FIFSW and Director of the Institute for Life Course and Aging at the University of Toronto. "These findings emphasize the importance of mentoring interventions and other community-based supports that may promote feelings of safety and trust among neglected children, and to ensure neglected children have the resources and encouragement to remain in school as long as possible."