Study of 1m children shows adversity increases risk of premature death in adulthood

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A new study published in The Lancet, conducted by researchers from the Universities of Copenhagen and Liverpool, shows that adversity in childhood increases the risk of premature death in early adulthood.

Children who have experienced repeated serious adversity such as losing a parent, mental illness in the family, poverty or being placed in foster care have a 4.5 times higher risk of dying in early adulthood than children who have not experienced adversity during childhood.

Childhood is a sensitive period with rapid brain development and physiological growth, and adverse events in childhood might interfere with these processes and have long-lasting effects on health.

Childhood adversities

In order to gain a better understanding of how these adverse events in childhood relate to mortality in early adult life researchers conducted a study that recorded repeated serious adversity in childhood among one million Danish children and then examined their mortality rates between 16 and 34 years.

Three dimensions of childhood adversities were identified by the researchers: poverty and material deprivation, loss or threat of loss within the family, and aspects of family dynamics such as maternal separation.

The researchers divided the children into five groups depending on the degree of adversity experienced in childhood.

Findings

The researchers found that the more stressful experiences they have experienced during childhood, the higher the mortality rate in early adulthood.

In group 1: 54 % of the children experienced no or only very few isolated incidents of adversity in childhood.

in groups 2-4: 43 % of the children experienced isolated incidents of adversity in childhood, mainly related to poverty or illness in the family. Here the researchers found a mortality rate in early adulthood that is 1.3-1.8 times higher than in Group 1.

in group 5: 3 % experienced multiple adversities within all dimensions and throughout the entire childhood period. In this group, the mortality rate is 4.5 times higher than in Group 1.

The higher mortality rate mainly manifests itself in suicide and accidents, but the study also shows a higher risk of dying from cancer in this group.

Protection from poverty and material deprivation

Professor David Taylor-Robinson, University of Liverpool, said: “Child poverty and adversity damages health across the lifespan even in Denmark where levels of poverty are much lower than in the UK. These findings are really concerning given the current UK context where over 1 in 3 children lives in poverty and this is predicted to rise. It is time for the government to reverse this trend establishing a welfare system that protects children from poverty and material deprivation.

“We know that childhood adversity has a myriad of adverse impacts on multiple aspects of child health and development that will have repercussions for decades to come. The results of the study stress the critical importance of broad structural public-health initiatives to reduce poverty and prevent adversity in childhood as well as appropriate support for vulnerable children who experience severe adversities.”

Action needed to minimise social adversity

Naja Hulvej Rod, University of Copenhagen, said: “It is striking to see such a strong connection between adversity in childhood and mortality in the Danish welfare state, which among other things aims to promote financial stability among families with young children and to minimise social adversity. From an international perspective, you may worry that these associations are even stronger in a less extensive welfare system.”

The study is the first of its kind on a global basis. The size of the study in a total population has made it possible for the researchers to study the associations between incidents of social and stressful adversity throughout childhood and how it affects mortality rates among young adults.

The study, ‘Trajectories of childhood adversity and mortality in early adulthood: A population-based cohort study’, can be found here.

https://doi.org/10.1016/S0140-6736(20)30621-8