The "long arm" of adverse childhood experiences on adult health depreciation in China

Background: The effects of childhood adversity on health may persist into the middle and oldaged. The assessment of the long-term effect of adverse childhood experiences (ACE) on adult health depreciation promotes a paradigm shift from current factors in health to early causation shaping health life course trajectories. Objective: Determine whether the direct and significant dose-response effect between childhood adversity and health depreciation holds true, and to examine whether socioeconomic status (SES) in adulthood can diminish the negative effects of ACE. Methods: A sample of 6344 nationally representative respondents (48 % were male; Mage = 64.48 years old, SD = 9.6 years old) was obtained. Adverse childhood experiences were collected from a Life History survey in China. Health depreciation was assessed by years lived with disabilities (YLDs) based on the Global Burden of Disease (GBD) disability weights. Ordinary least squares and matching methods (propensity score matching and coarsened exact matching) were used to test the relationship and treatment effect between ACEs and health depreciation. Mediating effect coefficients test and the Karlson-Holm-Breen (KHB) examined the mediating effect of socioeconomic status in adulthood.Results: Compared to respondents without ACE, respondents who experienced 1 ACE increased YLD 15.9 % (p < 0.01); 2 ACEs by 32.8 % (p < 0.01); 3 ACEs by 47.4 % (p < 0.01), and 4+ ACEs by 71.5 % (p < 0.01) higher YLDs. The mediating effect of SES in adulthood was only between 3.9 % and 8.2 %. The interaction effect between ACE and adult socioeconomic status was not significant.Conclusion: The "long arm" of ACE on health depreciation exhibited a significant dose-response relationship. Policies and measures aimed at reducing family dysfunction and strengthening early childhood health interventions can facilitate the reduction of health depreciation in middle and old age.