Effect of family-related adverse childhood experiences on self-rated health in childhood and adulthood--childhood friendships as moderator.

Although many existing studies have shown that family-related adverse childhood experiences (ACEs) have a negative effect on individual health, few studies have examined the role of childhood friendships in the relationship between ACEs and health outcomes. The present study used ordered logistic regression analyze the data from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2014, which is a national representative survey, to investigate the impact of family-related ACEs on self-rated health in childhood and adulthood and the moderating effects of childhood friendships. We found that respondents whose ACEs included physical and emotional neglect, parental physical illness, parental mental illness, family economic hardship, experience of starvation, lived in insecure neighborhood, and lived in unclean community, had a lower self-rated health in childhood and adulthood than those without ACEs. Peer relationship moderates the impact of family-related ACEs-namely, family economic hardship and parental physical illness-on health outcomes, and the increase of peer relationship can reduce adverse effects. Our findings suggest that family-related ACEs are not only related to health in the early life, but also to health outcomes in adulthood. Childhood friendships can reduce the adverse effects of ACEs on health outcomes throughout an individual's life course. Therefore, it is necessary to actively cultivate children's peer relationship networks and improve the quality of childhood friendship.