Adverse childhood experiences: retrospective study to determine their impact on adult health behaviours and health outcomes in a UK population

J Public Health (Oxf). 2014 Mar;36(1):81-91. doi: 10.1093/pubmed/fdt038. Epub 2013 Apr 14.


Background: Studies suggest strong links between adverse childhood experiences (ACEs) and poor adult health and social outcomes. However, the use of such studies in non-US populations is relatively scarce.

Methods: Retrospective cross-sectional survey of 1500 residents and 67 substance users aged 18-70 years in a relatively deprived and ethnically diverse UK population.

Results: Increasing ACEs were strongly related to adverse behavioural, health and social outcomes. Compared with those with 0 ACEs, individuals with 4+ ACEs had adjusted odds ratios of the following: 3.96 [95% confidence interval (CI): 2.74-5.73] for smoking; 3.72 (95% CI: 2.37-5.85) for heavy drinking; 8.83 (95% CI: 4.42-17.62) for incarceration and 3.02 (95% CI: 1.38-6.62) for morbid obesity. They also had greater risk of poor educational and employment outcomes; low mental wellbeing and life satisfaction; recent violence involvement; recent inpatient hospital care and chronic health conditions. Higher ACEs were also associated with having caused/been unintentionally pregnant aged <18 years and having been born to a mother aged <20 years.

Conclusions: ACEs contribute to poor life-course health and social outcomes in a UK population. That ACEs are linked to involvement in violence, early unplanned pregnancy, incarceration, and unemployment suggests a cyclic effect where those with higher ACE counts have higher risks of exposing their own children to ACEs.

Keywords: childhood experiences; chronic disease; substance use; violence; wellbeing.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Alcoholism / epidemiology
  • Alcoholism / etiology
  • Child
  • Crime / statistics & numerical data
  • Cross-Sectional Studies
  • Educational Status
  • Employment / statistics & numerical data
  • Female
  • Health Behavior*
  • Health Status*
  • Humans
  • Male
  • Middle Aged
  • Obesity, Morbid / epidemiology
  • Obesity, Morbid / etiology
  • Psychology, Child*
  • Retrospective Studies
  • Smoking / epidemiology
  • Surveys and Questionnaires
  • United Kingdom / epidemiology
  • Young Adult