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Adverse Childhood Exposures and Reported Child Health at Age 12

  • Emalee G. Flaherty
    Correspondence
    Address correspondence to Emalee G. Flaherty, MD, Children's Memorial Hospital, 2300 Children's Plaza, Box 16, Chicago, Illinois 60614.
    Affiliations
    Department of Pediatrics, Children's Memorial Hospital and Northwestern University's Feinberg School of Medicine, Chicago, Ill (Dr Flaherty); Department of Research, Juvenile Protective Association, Chicago, Ill (Dr Thompson); Department of Psychology, San Diego State and Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California at San Diego, San Diego, Calif (Dr Litrownik); Department of Family Medicine, University of North Carolina, Chapel Hill, NC (Dr Zolotor); Department of Pediatrics, University of Maryland, Baltimore, Md (Dr Dubowitz); Department of Social Medicine, Pediatrics, University of North Carolina, Chapel Hill, NC (Dr Runyan); School of Social Work, University of Washington, Seattle, Wash (Dr English); and Department of Psychiatry, University of North Carolina, Chapel Hill, NC (Dr Everson)
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  • Richard Thompson
    Affiliations
    Department of Pediatrics, Children's Memorial Hospital and Northwestern University's Feinberg School of Medicine, Chicago, Ill (Dr Flaherty); Department of Research, Juvenile Protective Association, Chicago, Ill (Dr Thompson); Department of Psychology, San Diego State and Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California at San Diego, San Diego, Calif (Dr Litrownik); Department of Family Medicine, University of North Carolina, Chapel Hill, NC (Dr Zolotor); Department of Pediatrics, University of Maryland, Baltimore, Md (Dr Dubowitz); Department of Social Medicine, Pediatrics, University of North Carolina, Chapel Hill, NC (Dr Runyan); School of Social Work, University of Washington, Seattle, Wash (Dr English); and Department of Psychiatry, University of North Carolina, Chapel Hill, NC (Dr Everson)
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  • Alan J. Litrownik
    Affiliations
    Department of Pediatrics, Children's Memorial Hospital and Northwestern University's Feinberg School of Medicine, Chicago, Ill (Dr Flaherty); Department of Research, Juvenile Protective Association, Chicago, Ill (Dr Thompson); Department of Psychology, San Diego State and Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California at San Diego, San Diego, Calif (Dr Litrownik); Department of Family Medicine, University of North Carolina, Chapel Hill, NC (Dr Zolotor); Department of Pediatrics, University of Maryland, Baltimore, Md (Dr Dubowitz); Department of Social Medicine, Pediatrics, University of North Carolina, Chapel Hill, NC (Dr Runyan); School of Social Work, University of Washington, Seattle, Wash (Dr English); and Department of Psychiatry, University of North Carolina, Chapel Hill, NC (Dr Everson)
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  • Adam J. Zolotor
    Affiliations
    Department of Pediatrics, Children's Memorial Hospital and Northwestern University's Feinberg School of Medicine, Chicago, Ill (Dr Flaherty); Department of Research, Juvenile Protective Association, Chicago, Ill (Dr Thompson); Department of Psychology, San Diego State and Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California at San Diego, San Diego, Calif (Dr Litrownik); Department of Family Medicine, University of North Carolina, Chapel Hill, NC (Dr Zolotor); Department of Pediatrics, University of Maryland, Baltimore, Md (Dr Dubowitz); Department of Social Medicine, Pediatrics, University of North Carolina, Chapel Hill, NC (Dr Runyan); School of Social Work, University of Washington, Seattle, Wash (Dr English); and Department of Psychiatry, University of North Carolina, Chapel Hill, NC (Dr Everson)
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  • Howard Dubowitz
    Affiliations
    Department of Pediatrics, Children's Memorial Hospital and Northwestern University's Feinberg School of Medicine, Chicago, Ill (Dr Flaherty); Department of Research, Juvenile Protective Association, Chicago, Ill (Dr Thompson); Department of Psychology, San Diego State and Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California at San Diego, San Diego, Calif (Dr Litrownik); Department of Family Medicine, University of North Carolina, Chapel Hill, NC (Dr Zolotor); Department of Pediatrics, University of Maryland, Baltimore, Md (Dr Dubowitz); Department of Social Medicine, Pediatrics, University of North Carolina, Chapel Hill, NC (Dr Runyan); School of Social Work, University of Washington, Seattle, Wash (Dr English); and Department of Psychiatry, University of North Carolina, Chapel Hill, NC (Dr Everson)
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  • Desmond K. Runyan
    Affiliations
    Department of Pediatrics, Children's Memorial Hospital and Northwestern University's Feinberg School of Medicine, Chicago, Ill (Dr Flaherty); Department of Research, Juvenile Protective Association, Chicago, Ill (Dr Thompson); Department of Psychology, San Diego State and Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California at San Diego, San Diego, Calif (Dr Litrownik); Department of Family Medicine, University of North Carolina, Chapel Hill, NC (Dr Zolotor); Department of Pediatrics, University of Maryland, Baltimore, Md (Dr Dubowitz); Department of Social Medicine, Pediatrics, University of North Carolina, Chapel Hill, NC (Dr Runyan); School of Social Work, University of Washington, Seattle, Wash (Dr English); and Department of Psychiatry, University of North Carolina, Chapel Hill, NC (Dr Everson)
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  • Diana J. English
    Affiliations
    Department of Pediatrics, Children's Memorial Hospital and Northwestern University's Feinberg School of Medicine, Chicago, Ill (Dr Flaherty); Department of Research, Juvenile Protective Association, Chicago, Ill (Dr Thompson); Department of Psychology, San Diego State and Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California at San Diego, San Diego, Calif (Dr Litrownik); Department of Family Medicine, University of North Carolina, Chapel Hill, NC (Dr Zolotor); Department of Pediatrics, University of Maryland, Baltimore, Md (Dr Dubowitz); Department of Social Medicine, Pediatrics, University of North Carolina, Chapel Hill, NC (Dr Runyan); School of Social Work, University of Washington, Seattle, Wash (Dr English); and Department of Psychiatry, University of North Carolina, Chapel Hill, NC (Dr Everson)
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  • Mark D. Everson
    Affiliations
    Department of Pediatrics, Children's Memorial Hospital and Northwestern University's Feinberg School of Medicine, Chicago, Ill (Dr Flaherty); Department of Research, Juvenile Protective Association, Chicago, Ill (Dr Thompson); Department of Psychology, San Diego State and Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California at San Diego, San Diego, Calif (Dr Litrownik); Department of Family Medicine, University of North Carolina, Chapel Hill, NC (Dr Zolotor); Department of Pediatrics, University of Maryland, Baltimore, Md (Dr Dubowitz); Department of Social Medicine, Pediatrics, University of North Carolina, Chapel Hill, NC (Dr Runyan); School of Social Work, University of Washington, Seattle, Wash (Dr English); and Department of Psychiatry, University of North Carolina, Chapel Hill, NC (Dr Everson)
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      Objective

      The relationship between adverse childhood exposures and poor health, illness, and somatic complaints at age 12 was examined.

      Methods

      LONGSCAN (Consortium for Longitudinal Studies of Child Abuse and Neglect) tracks a group of children with variable risk for maltreatment. Of the participating child-caregiver dyads, 805 completed an interview when the child was age 4 or age 6, as well as interviews at age 8 and 12. The relationships between 8 categories of childhood adversity (psychological maltreatment, physical abuse, sexual abuse, child neglect, caregiver's substance/alcohol use, caregiver's depressive symptoms, caregiver's being treated violently, and criminal behavior in the household) and child health at age 12 were analyzed. The impact of adversity in the first 6 years of life and adversity in the second 6 years of life on child health were compared.

      Results

      Only 10% of the children had experienced no adversity, while more than 20% had experienced 5 or more types of childhood adversity. At age 12, 37% of the children sampled had some health complaint. Exposure to 5 or more adversities, particularly exposure in the second 6 years of life, was significantly associated with increased risks of any health complaint (odds ratio [OR] 2.24, 95% confidence interval [95% CI] 1.02–4.96), an illness requiring a doctor (OR 3.69, 95% CI 1.02–15.1), and caregivers’ reports of child's somatic complaints (OR 3.37, 95% CI 1.14–1.0). There was no association between adverse exposures and self-rated poor health or self-rated somatic complaints.

      Conclusions

      A comprehensive assessment of children's health should include a careful history of their past exposure to adverse conditions and maltreatment. Interventions aimed at reducing these exposures may result in better child health.

      Key Words

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