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Adverse childhood experiences and adult health: the need for stronger study designs to evaluate impact
  1. G David Batty,
  2. Mika Kivimaki
  1. Department of Epidemiology and Public Health, University College London, London, UK
  1. Correspondence to Professor G David Batty, Department of Epidemiology and Public Health, University College London, London, UK; david.batty{at}

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Early life is regarded as a crucial period of neurobiological, emotional, social and physical development in all animal species and may have long-term implications for health across the life course. The first studies examining the preadult origins of chronic disease were probably published more than 50 years ago and based on rodent models.1 By briefly administering a suboptimal diet to newborn mice, Dubos and others1 demonstrated a marked impact on subsequent growth and resistance to infection. In the 1970s, Forsdahl,2 using infant mortality rates as a proxy for living conditions at birth, arguably provided the first evidence in humans for an association with heart disease in later life. In the last two decades, findings from longitudinal studies with extended mortality and morbidity surveillance have implicated a host of preadult characteristics as potential risk factors for several chronic disease outcomes, including perinatal and postnatal growth,3 coordination,4 intelligence,5 6 mental health,7 overweight,8 9 physical stature,10 raised blood pressure,11 12 cigarette smoking,13 physical strength14 and diet15 among many others.16

An array of prospective studies has also demonstrated associations of childhood socioeconomic disadvantage–indexed by paternal social class or education, the presence of household amenities and domestic overcrowding—with somatic health outcomes in adulthood, chiefly premature mortality and cardiovascular disease.17 18 Parallel work has been undertaken by psychologists and psychiatrists exploring the consequences of childhood maltreatment for later psychopathologies—perhaps the most well examined health endpoint in this context.19 20 Collectively, these early life circumstances have been more widely defined to comprise the separate themes of material deprivation (eg, economic hardship and long-term unemployment); stressful family dynamics (eg, physical and emotional abuse, psychiatric illness or substance abuse by a family member); loss or threat of loss (eg, death or serious illness …

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  • Contributors GDB generated the idea for the editorial, drafted a plan, and wrote the first draft of the manuscript. MK drafted a plan and edited the manuscript.

  • Funding GDB is partially supported by the UK Medical Research Council (MR/P023444/1) and the US National Institute on Aging (1R56AG052519-01; 1R01AG052519-01A1); MK by the UK Medical Research Council, NordForsk (the Nordic Research Programme on Health and Welfare) and the Academy of Finland (311472).

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.