Childhood abuse doubles adult risk of chronic health conditions

A new study published this week in Child Maltreatment found that in comparison to those who had not been abused in childhood, adults who had experienced both childhood physical and sexual abuse had approximately double the odds of physical and mental health conditions, including angina, arthritis, asthma, COPD, heart attack, depression, and disability -- even after considering respondents' age, race, income, and health behaviors, as well as obesity.

Those who had been sexually abused, but not physically abused, were 55% to 90% more likely to experience these health outcomes compared to their peers who had not experienced any abuse. Adults who were physically abused, but not sexually abused, also had significantly elevated odds of these health outcomes compared to the non-abused, but the associations were more modest (between 20% to 50%).

"People don't typically think about the impact early adversities can have on health outcomes later in life," says first author Shannon Halls, a Research Coordinator at University of Toronto's Institute for Life Course and Aging.

Our research underscores the harmful associations between early adversities, such as sexual and/or physical abuse, and a wide range of health issues in adulthood."

Shannon Halls, Research Coordinator, Institute for Life Course and Aging, University of Toronto

In exploring this association, the study also examined whether the presence of an adult in the home who made the child feel safe and protected was associated with better long-term health outcomes among children who experienced abuse.

"We found that when children experiencing abuse had a protective adult in their home, the negative impact of abuse on their health as adults was less severe," says co-author Andie MacNeil, a doctoral student at the Factor-Inwentash Faculty of Social Work (FIFSW).

"Though more research is needed to pinpoint the precise mechanisms, it is evident that these relationships can play a key role in supporting children and mitigating the adverse health effects of abuse."

The presence of a protective adult was not only important for children who had experienced abuse, but important for children who had not been abused as well. Children without a protective adult in their home, irrespective of childhood abuse status, were 20% to 40% more likely to experience adverse physical health outcomes and twice as likely to suffer from depression in adulthood.

"The implication here is that lacking the safe and stable relationships with adults can be just as harmful to children's health as being physically abused," says senior author Esme Fuller-Thomson, a Professor at FIFSW and Director for the Institute of Life Course and Aging at the University of Toronto.

The study's authors point to the need for future research to unpack these findings in particular.

"It will be important in future research to investigate why some adults in the home are not adequately protective of children, and to discuss potential primary prevention interventions that can help parents provide a more protective environment for children," said co-author Philip Baiden, an Associate Professor in the School of Social Work at the University of Texas at Arlington

The study analyzed data from the 2021 and 2022 Behavioural Risk Factor Surveillance System, a large representative sample from which over 80,000 adult U.S. respondents were included.

"Our research shows the importance of positive relationships between children and the adults in their lives" says Halls. "We hope that these findings can contribute to a better understanding for creating effective programs targeted at children experiencing abuse."