The relationship of adverse childhood experiences to a history of premature death of family members.
BACKGROUND
To assess the association between adverse childhood experiences (ACEs), including childhood abuse and neglect, and serious household dysfunction, and premature death of a family member. Because ACEs increase the risk for many of the leading causes of death in adults and tend to be familial and intergenerational, we hypothesized that persons who report having more ACEs would be more likely to have family members at risk of premature death.


METHODS
We used data from 17,337 adult health plan members who completed a survey about 10 types of ACEs and whether a family member died before age 65. The prevalence of family member premature death and its association with ACEs were assessed.


RESULTS
Family members of respondents who experienced any type of ACEs were more likely to have elevated prevalence for premature death relative to those of respondents without such experience (p < 0.01). The highest risk occurred among those who reported having been physically neglected and living with substance abusing or criminal family members during childhood. A powerful graded relationship between the number of ACEs and premature mortality in the family was observed for all age groups, and comparison between groups reporting 0 ACE and >or= 4 ACEs yielded an OR of 1.8 (95%CI, 1.6-2.0).


CONCLUSIONS
Adverse childhood experiences may be an indicator of a chaotic family environment that results in an increased risk of premature death among family members.
ACE Study Group, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. rfa1@cdc.gov
Robert F
RF
Anda
Maxia
M
Dong
David W
DW
Brown
Vincent J
VJ
Felitti
Wayne H
WH
Giles
Geraldine S
GS
Perry
Edwards J
EJ
Valerie
Shanta R
SR
Dube
D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000706:statistics & numerical data*; D005195:Family Relations; D005260:Female; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D009026:Mortality; D017064:Process Assessment, Health Care; D012189:Retrospective Studies; D011795:Surveys and Questionnaires