Effect of early childhood adversity on child health

Arch Pediatr Adolesc Med. 2006 Dec;160(12):1232-8. doi: 10.1001/archpedi.160.12.1232.


Objective: To examine the effect of child abuse and other household dysfunction on child health outcomes.

Design: Data from the Longitudinal Studies of Child Abuse and Neglect collected through interviews and questionnaires administered when target children were 4 years old and 6 years old.

Setting: Children in the South, East, Midwest, Northwest, and Southwest United States.

Participants: One thousand forty-one children at high risk for child abuse and neglect (3 cohorts derived primarily from among children recruited through social service mechanisms, 1 cohort recruited at birth from among high-risk infants, and 1 cohort recruited from a medical setting).

Main outcome measures: (1) Association of 7 adverse exposures (3 categories of child abuse [physical abuse, sexual abuse, and psychological maltreatment] and 4 categories of household dysfunction [caregiver problem drinking, caregiver depression, caregiver treated violently, and criminal behavior in the household]) derived from data collected when the child was 4 years old. (2) Indexes of child physical health at age 6 years (caregiver overall assessment of child health and reports of illness requiring medical attention).

Results: Two thirds of the sample had experienced at least 1 adverse exposure. One adverse exposure almost doubled the risk of overall poor health (odds ratio, 1.89; 95% confidence interval, 1.02-3.48), and 4 adverse exposures or more almost tripled the risk of illness requiring medical attention (odds ratio, 2.83; 95% confidence interval, 1.10-7.31).

Conclusion: Adverse environmental exposures, including child abuse and other household dysfunction, are associated with poor child health even at an early age, although our data do not support a dose-response relationship.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alcoholism*
  • Caregivers
  • Child
  • Child Abuse / statistics & numerical data*
  • Child of Impaired Parents / statistics & numerical data*
  • Child, Preschool
  • Depression*
  • Family Relations
  • Female
  • Health Status*
  • Humans
  • Male
  • Risk Factors
  • Spouse Abuse*
  • Surveys and Questionnaires
  • United States