Adverse childhood experiences and premature all-cause mortality

Eur J Epidemiol. 2013 Sep;28(9):721-34. doi: 10.1007/s10654-013-9832-9. Epub 2013 Jul 26.


Events causing stress responses during sensitive periods of rapid neurological development in childhood may be early determinants of all-cause premature mortality. Using a British birth cohort study of individuals born in 1958, the relationship between adverse childhood experiences (ACE) and mortality≤50 year was examined for men (n=7,816) and women (n=7,405) separately. ACE were measured using prospectively collected reports from parents and the school: no adversities (70%); one adversity (22%), two or more adversities (8%). A Cox regression model was carried out controlling for early life variables and for characteristics at 23 years. In men the risk of death was 57% higher among those who had experienced 2+ ACE compared to those with none (HR 1.57, 95% CI 1.13, 2.18, p=0.007). In women, a graded relationship was observed between ACE and mortality, the risk increasing as ACE accumulated. Women with one ACE had a 66% increased risk of death (HR 1.66, 95% CI 1.19, 2.33, p=0.003) and those with ≥2 ACE had an 80% increased risk (HR 1.80, 95% CI 1.10, 2.95, p=0.020) versus those with no ACE. Given the small impact of adult life style factors on the association between ACE and premature mortality, biological embedding during sensitive periods in early development is a plausible explanatory mechanism.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child Abuse / psychology*
  • Child Abuse / statistics & numerical data
  • Child of Impaired Parents / statistics & numerical data
  • Female
  • Humans
  • Life Change Events*
  • Male
  • Middle Aged
  • Mortality, Premature*
  • Multivariate Analysis
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors
  • Social Environment
  • Stress, Psychological / psychology*
  • United Kingdom
  • Young Adult