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Childhood adversity and adult health: Evaluating intervening mechanisms


  • Turner, R. Jay
  • Thomas, Courtney S.
  • Brown, Tyson H.


Substantial evidence has accumulated supporting a causal link between childhood adversity and risk for poor health years and even decades later. One interpretation of this evidence is that this linkage arises largely or exclusively from a process of biological embedding that is not modifiable by subsequent social context or experience – implying childhood as perhaps the only point at which intervention efforts are likely to be effective. This paper considers the extent to which this long-term association arises from intervening differences in social context and/or environmental experiences – a finding that would suggest that post-childhood prevention efforts may also be effective. Based on the argument that the selected research definition of adult health status may have implications for the early adversity-adult health linkage, we use a representative community sample of black and white adults (N = 1252) to evaluate this relationship across three health indices: doctor diagnosed illnesses, self-rated health, and allostatic load. Results generally indicate that observed relationships between childhood adversity and dimensions of adult health status were totally or almost totally accounted for by variations in adult socioeconomic position (SEP) and adult stress exposure. One exception is the childhood SEP-allostatic load association, for which a statistically significant relationship remained in the context of adult stress and SEP. This lone finding supports a conclusion that the impact of childhood adversity is not always redeemable by subsequent experience. However, in general, analyses suggest the likely utility of interventions beyond childhood aimed at reducing exposure to social stress and improving social and economic standing. Whatever the effects on adult health that derive from biological embedding, they appear to be primarily indirect effects through adult social context and exposure.

Suggested Citation

  • Turner, R. Jay & Thomas, Courtney S. & Brown, Tyson H., 2016. "Childhood adversity and adult health: Evaluating intervening mechanisms," Social Science & Medicine, Elsevier, vol. 156(C), pages 114-124.
  • Handle: RePEc:eee:socmed:v:156:y:2016:i:c:p:114-124
    DOI: 10.1016/j.socscimed.2016.02.026

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    References listed on IDEAS

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    6. Mark Hayward & Bridget Gorman, 2004. "The long arm of childhood: The influence of early-life social conditions on men’s mortality," Demography, Springer;Population Association of America (PAA), vol. 41(1), pages 87-107, February.
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    11. Warner, David F. & Brown, Tyson H., 2011. "Understanding how race/ethnicity and gender define age-trajectories of disability: An intersectionality approach," Social Science & Medicine, Elsevier, vol. 72(8), pages 1236-1248, April.
    12. Jenifer Hamil-Luker & Angela O’rand, 2007. "Gender differences in the link between childhood socioeconomic conditions and heart attack risk in adulthood," Demography, Springer;Population Association of America (PAA), vol. 44(1), pages 137-158, February.
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    Cited by:

    1. repec:oup:geronb:v:73:y:2018:i:2:p:188-197. is not listed on IDEAS
    2. Yang, Tse-Chuan & Chen, I-Chien & Choi, Seung-won & Kurtulus, Aysenur, 2019. "Linking perceived discrimination during adolescence to health during mid-adulthood: Self-esteem and risk-behavior mechanisms," Social Science & Medicine, Elsevier, vol. 232(C), pages 434-443.
    3. repec:oup:geronb:v:73:y:2018:i:2:p:208-218. is not listed on IDEAS
    4. Davillas, A.; Jones, A.M.; Benzeval, M.;, 2017. "The income-health gradient: Evidence from self-reported health and biomarkers using longitudinal data on income," Health, Econometrics and Data Group (HEDG) Working Papers 17/04, HEDG, c/o Department of Economics, University of York.
    5. Hannes Kröger & Rasmus Hoffmann & Lasse Tarkiainen & Pekka Martikainen, 2018. "Comparing Observed and Unobserved Components of Childhood: Evidence From Finnish Register Data on Midlife Mortality From Siblings and Their Parents," Demography, Springer;Population Association of America (PAA), vol. 55(1), pages 295-318, February.
    6. Mersky, Joshua P. & Janczewski, Colleen E. & Nitkowski, Jenna C., 2018. "Poor mental health among low-income women in the U.S.: The roles of adverse childhood and adult experiences," Social Science & Medicine, Elsevier, vol. 206(C), pages 14-21.
    7. Berg, Mark T. & Simons, Ronald L. & Barr, Ashley & Beach, Steven R.H. & Philibert, Robert A., 2017. "Childhood/Adolescent stressors and allostatic load in adulthood: Support for a calibration model," Social Science & Medicine, Elsevier, vol. 193(C), pages 130-139.


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