title: Childhood Adversities and Adult Cardiometabolic Health: Does the Quantity, Timing, and Type of Adversity Matter?
abstract: OBJECTIVE
  Adverse events in childhood can indelibly influence adult health. While evidence for this association has mounted, a fundamental set of questions about how to operationalize adverse events has been understudied.
  
  
  METHODS
  We used data from the National Survey of Midlife Development in the United States to examine how quantity, timing, and types of adverse events in childhood are associated with adult cardiometabolic health.
  
  
  RESULTS
  The best-fitting specification of quantity of events was a linear measure reflecting a dose-response relationship. Timing of event mattered less than repeated exposure to events. Regarding the type of event, academic interruptions and sexual/physical abuse were most important. Adverse childhood events elevated the risk of diabetes and obesity similarly for men and women but had a greater impact on women's risk of heart disease.
  
  
  CONCLUSIONS
  Findings demonstrate the insights that can be gleaned about the early-life origins of adult health by examining operationalization of childhood exposures.
authors.affiliation: RAND Corporation, Santa Monica, CA, USA friedman@rand.org.
authors.forename: Esther M
authors.initials: EM
authors.lastname: Friedman
authors.affiliation: Syracuse University, Syracuse, NY.
authors.forename: Jennifer Karas
authors.initials: JK
authors.lastname: Montez
authors.affiliation: University of Texas at Austin, USA.
authors.forename: Connor McDevitt
authors.initials: CM
authors.lastname: Sheehan
authors.affiliation: University of Southern California, Los Angeles, USA.
authors.forename: Tara L
authors.initials: TL
authors.lastname: Guenewald
authors.affiliation: University of California, Los Angeles, USA.
authors.forename: Teresa E
authors.initials: TE
authors.lastname: Seeman
mesh_terms: D000328:Adult; D000069586:Adult Survivors of Child Adverse Events / Q000706:statistics & numerical data*; D000368:Aged; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006331:Heart Diseases / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D012306:Risk; D013997:Time Factors; D014481:United States / Q000453:epidemiology
keywords: childhood; diabetes; gender; heart disease; life course; midlife; obesity