Differing trajectories of adversity over the life course: Implications for adult health and well-being.

BACKGROUND

Adverse childhood experiences (ACE), can give rise to long-term mental and physical health consequences as well as additional stressors later in the life course. This study aims to examine differing profiles of trajectories of adversity over the life course and investigate their association with socioeconomic and health outcomes.

METHODS

We used population representative data from the Washington State 2011 Behavioral Risk Factor Surveillance System BRFSS survey n = 7953. Six ACE items were paired with six Adverse Adulthood Experience AAE items in respondents' adulthood that parallel the ACE e.g. physical abuse in childhood and physical victimization in adulthood. We applied latent class analysis to identify distinct trajectories of adversity; then tested for differences across trajectories in terms of demographic, socioeconomic, and health measures.

RESULTS

Six latent classes were identified: individuals with high AAE: (1. Consistently High, 2. Substance Abuse and Incarceration, 3. Adult Interpersonal Victimization) and individuals with low AAE (4. Repeat Sexual Victimization, 5. High to Low, and 6. Consistently Low). The Consistently High group had the highest prevalence of ACE and AAE and fared poorly across wide ranging outcomes. Other groups displayed specific patterns of ACE and AAE exposures (including salient subgroups such as those with incarceration exposure) as well as differences in demographic characteristics, illustrating disparities.

CONCLUSIONS

Subgroup analyses such as this are complementary to population generalized findings. Understanding differences in life course patterns of adversity can shed light on interventions in earlier life and better target service provision to promote health and well-being.