The DOI matches its Crossref record; 25 of the 25 references it cites were found in a registry or an index.
Trajectories of childhood adversity and mortality in early adulthood: a population-based cohort study
Abstract
Background Childhood is a sensitive period with rapid brain development and physiological growth, and adverse events in childhood might interfere with these processes and have long-lasting effects on health. In this study, we aimed to describe trajectories of adverse childhood experiences and relate these to overall and cause-specific mortality in early adult life.Methods For this population-based cohort study, we used unselected annually updated data from Danish nationwide registers covering more than 1 million children born between 1980 and 1998. We distinguished between three different dimensions of childhood adversities: poverty and material deprivation, loss or threat of loss within the family, and aspects of family dynamics such as maternal separation. We used a group-based multi-trajectory clustering model to define the different trajectories of children aged between 0 and 16 years. We assessed the associations between these trajectories and mortality rates between 16 and 34 years of age using a Cox proportional hazards model and an Aalen hazards difference model.Findings Between Jan 1, 1980 and Dec 31, 2015, 2 223 927 children were included in the Danish Life Course cohort. We excluded 1 064 864 children born after 1998, 50 274 children who emigrated before their 16th birthday, and 11 161 children who died before their 16th birthday, resulting in a final sample of 1 097 628 children. We identified five distinct trajectories of childhood adversities. Compared with children with a low adversity trajectory, those who had early-life material deprivation (hazard ratio 1·38, 95% CI 1·27-1·51), persistent deprivation (1·77, 1·62-1·93), or loss or threat of loss (1·80, 1·61-2·00) had a moderately higher risk of premature mortality. A small proportion of children (36 081 [3%]) had multiple adversities within all dimensions and throughout the entire childhood. This group had a 4·54 times higher all-cause mortality risk (95% CI 4·07-5·06) than that of children with a low adversity trajectory, corresponding to 10·30 (95% CI 9·03-11·60) additional deaths per 10 000 person-years. Accidents, suicides, and cancer were the most common causes of death in this high adversity population.Interpretation Almost half of Danish children in our study experienced some degree of adversity, and this was associated with a moderately higher risk of mortality in adulthood. Among these, a small group of children had multiple adversities across social, health, and family-related dimensions. This group had a markedly higher mortality risk in early adulthood than that of other children, which requires public health attention.Funding None.
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“Evidence also points to children experiencing multiple adversities in childhood having a markedly increased all-cause mortality risk in adulthood [9].”
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The Lifelong Effects of Early Childhood Adversity and Toxic Stress
Shonkoff, J. P., Garner, A. S., THE COMMITTEE ON PSYCHOSOCIAL ASPECTS OF CHILD AND FAMILY HEALTH, C. O. E. C., Siegel, B. S., Dobbins, M. I., Earls, M. F., Garner, A. S., McGuinn, L., Pascoe, J., & Wood, D. L. (2012) · Pediatrics · doi:10.1542/peds.2011-2663 · Cited by 5,164
The Danish Civil Registration System as a tool in epidemiology
Schmidt, M., Pedersen, L. H., & Sørensen, H. T. (2014) · European Journal of Epidemiology · doi:10.1007/s10654-014-9930-3 · Cited by 3,486
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Evans, G. W., Li, D., & Whipple, S. S. (2013) · Psychological Bulletin · doi:10.1037/a0031808 · Cited by 2,024
Syndemics and the biosocial conception of health
Singer, M., Bulled, N., Ostrach, B., & Mendenhall, E. (2017) · The Lancet · doi:10.1016/s0140-6736(17)30003-x · Cited by 1,491
Group-based multi-trajectory modeling
Nagin, D., Jones, B., Passos, V. L., & Tremblay, R. (2018) · Statistical Methods in Medical Research · doi:10.1177/0962280216673085 · Cited by 824
Bellis, M. A., Hughes, K., Leckenby, N., Hardcastle, K. A., Perkins, C., & Lowey, H. (2015) · Journal of Public Health · doi:10.1093/pubmed/fdu065 · Cited by 391
Adverse childhood experiences and adult health
Felitti, V. J. (2009) · Academic Pediatrics · doi:10.1016/j.acap.2009.03.001 · Cited by 368
Childhood adversities as risk factors for onset and persistence of suicidal behaviour
Bruffaerts, R., Demyttenaere, K., Borges, G. L. G., Haro, J. M., Chiu, W. T., Hwang, I. H., Karam, E. G., Kessler, R. C., Sampson, N. A., Alonso, J., et al. (2010) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.109.074716 · Cited by 367
Adverse childhood experiences and premature all-cause mortality
Kelly-Irving, M., Lepage, B., Dedieu, D., Bartley, M., Blane, D., Grosclaude, P., Lang, T., & Delpierre, C. (2013) · European Journal of Epidemiology · doi:10.1007/s10654-013-9832-9 · Cited by 338
Research works printed but not linked: 1
- Bengtsson, 2019, Cohort profile: the DANish LIFE course (DANLIFE) cohort, BMJ Open, 9
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Diamond, L. M., & Alley, J. (2022) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2022.104720 · Cited by 412
Lin, L., Wang, H., Lu, C., Chen, W., & Guo, V. Y. (2021) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.30143 · Cited by 320
Brindle, R. C., Pearson, A., & Ginty, A. T. (2022) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2022.104530 · Cited by 123
Berring, L. L., Holm, T., Hansen, J. P., Delcomyn, C. L., Søndergaard, R., & Hvidhjelm, J. (2024) · Healthcare · doi:10.3390/healthcare12090908 · Cited by 126
Zhang, T., Kan, L., Jin, C.-B., & Shi, W.-M. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.12.058 · Cited by 83
Metadata
- Authors
- Rod, N. H., Bengtsson, J., Budtz-Jørgensen, E., Clipet-Jensen, C., Taylor-Robinson, D., Andersen, A.-M. N., Dich, N., & Rieckmann, A.
- Affiliations
- University of Copenhagen (DK)
- Corresponding author
- Rod, Naja H
- ORCID
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2020-08
- Volume
- 396
- Issue
- 10249
- Pages
- 489-497
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W3048611576
- Cited by
- 232
- References
- 25
- Citations by year
- 2026: 35 · 2025: 51 · 2024: 40 · 2023: 44 · 2022: 28 · 2021: 30 · 2020: 4
- FWCI
- 10.59
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Funders
- Medical Research Council (MR/P008577/1)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Health › Health disparities and outcomes
- Social Sciences › Sociology and Political Science › Child Welfare and Adoption
- Keywords
- childhood adversity, adverse childhood experiences, mortality trajectories, material deprivation, poverty, family loss, maternal separation, family dynamics, premature mortality, cause-specific mortality, accidents, suicide, cancer, life course epidemiology, developmental origins of health and disease, family breakdown, Denmark
- MeSH terms
- Adolescent, Adult, Cause of Death, Denmark, Family Characteristics, Female, Humans, Male, Maternal Deprivation, Mortality, Poverty, Registries, Proportional Hazards Models, Young Adult
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