Childhood Adversity Is Linked with Risky Health Behaviors and Negative Life Outcomes

Blurry shadow of a boy in black and white

Children often show remarkable resilience, but a wealth of survey data shows that repeated exposure to adversity in childhood can have a significant impacts on health and well-being later in life.

The first Adverse Childhood Experiences (ACE) survey, conducted between 1995 and 1997 in Southern California, asked 17,000 participants about their childhood experiences, including abuse (sexual, physical, and emotional), neglect, and family and household challenges (separated/divorced parents, mental illness in members of the household, alcohol and drug abuse, incarcerated family members, and intimate partner violence). The responses were confidential and cross-referenced with current health conditions reported by the participants.

In 2010, researchers conducted an expanded study in 10 states and the District of Columbia, asking more than 50,000 participants even more comprehensive questions about adverse childhood experiences and health outcomes.

The results from these studies show that the more adverse experiences a person had before they were 18 years old, the more negative outcomes they reported later in life. Stressful and violent experiences seemed to add up to a greater likelihood of negative outcomes for children no matter what kinds of adversity they experienced

The Centers for Disease Control and Prevention propose that these events start a chain of problems for youth, as difficult experiences strongly correlate with disrupted brain development in children and teens and social, emotional, and cognitive development later in life. As a consequence, problems in development are ultimately associated with health-risk behaviors later in life, such as early drinking, smoking, drug use, and risky sexual practices. People who pursue those risky health behaviors have been shown to experience higher rates of social problems, disease, disability, and even early mortality.

These findings offer a theoretical explanation for how childhood experiences might lead to problems in adulthood. And a 2014 research article in Psychological Science indicates that inflammation may be one biological pathway through which early adversity affects long-term outcomes, with data showing that childhood stress may lead to risky health behaviors and inflammation later in life.

The data from the ACE study also allowed researchers insights into specific kinds of adversity, including participants’ experiences with neglect and family-member imprisonment.

When researchers examined adults who had, as a child, lived with an incarcerated family member, they found a familiar pattern. They were 50% more likely to smoke regularly, 40% more likely to engage in heavy drinking, and 30% more likely to exhibit multiple risky behaviors than those who had not lived with an incarcerated family member.

The data suggest that Hispanic participants may be particularly at risk following adverse situations like family separation. Hispanic adults who had an incarcerated family member were 70% more likely to be current smokers, 50% more likely to be overweight or obese, 50% more likely to engage in binge drinking, and 3 times as likely to engage in heavy drinking. Moreover, they were twice as likely to have three or four risky behaviors at once compared with a Hispanic respondent who grew up without incarcerated family members.


Centers for Disease Control and Prevention. (2016). About the CDC-Kaiser ACE study.

Felitti, V. J.,  Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V. A., Koss, M. P., Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine.

Gilbert, L. K., Breiding, M. J., Merrick, M. T., Thompson, W. W., Ford, D. C., Dhingra, S. S., & Parks, S. E. (2015). Childhood adversity and adult chronic disease: An update from ten states and the District of Columbia, 2010. American Journal of Preventive Medicine, 48, 345–349.

Gjelsvik, A., Dumont, D. M., & Nunn, A. (2013). Incarceration of a household member and Hispanic health disparities: Childhood exposure and adult chronic disease risk behaviors. Preventing Chronic Disease, 10, E69. doi:10.5888/pcd10.120281

Whitfield, C. L., Anda, R. F., Dube, S. R., & Felitti, V. J. (2003). Violent childhood experiences and the risk of intimate partner violence in adults: Assessment in a large health maintenance organization. Journal of Interpersonal Violence, 18, 166–185. doi:10.1177/0886260502238733

Raposa, E. B., Bower, J. E., Hammen, C. L., Najman, J. M., & Brennan, P. A. (2014). A developmental pathway from early life stress to inflammation: The role of negative health behaviors. Psychological Science, 25(6), 1268-1274. doi:10.1177/0956797614530570

APS regularly opens certain online articles for discussion on our website. Effective February 2021, you must be a logged-in APS member to post comments. By posting a comment, you agree to our Community Guidelines and the display of your profile information, including your name and affiliation. Any opinions, findings, conclusions, or recommendations present in article comments are those of the writers and do not necessarily reflect the views of APS or the article’s author. For more information, please see our Community Guidelines.

Please login with your APS account to comment.