The Long-Term Health and Human Capital Consequences of Adverse Childhood Experiences in the Birth to Thirty Cohort: Single, Cumulative, and Clustered Adversity

• Type of Material: Article
• Authors: Sara N Naicker, University of Witwatersrand; Marilyn N Ahun, Harvard T.H. Chan School of Public Health; Sahba Besharati, University of Witwatersrand; Shane Norris, Emory University; Massimiliano Orri, McGill University; Linda M Richter, University of Witwatersrand
• Language: English
• Date: 2022-02-01
• Publisher: MDPI
• Publication Version: Final Published Version
• Copyright Statement: © 2022 by the authors.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.3390/ijerph19031799
• Title of Journal or Parent Work: INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
• Volume: 19
• Issue: 3
• Grant/Funding Information: The adult outcome data collection at 28 years of age was funded by the Bill & Melinda Gates Foundation, Seattle, WA (OPP1164115).
• Keywords: ADOLESCENTS; ACEs; adverse childhood experiences; Life Sciences & Biomedicine; Environmental Sciences; PHYSICAL ABUSE; ASSOCIATION; clustered adversity; MALTREATMENT; GENDER; human capital; MENTAL-HEALTH; Science & Technology; VIOLENCE; RISK-FACTORS; Public, Environmental & Occupational Health; SUBSTANCE USE; SOCIAL-ISOLATION; Environmental Sciences & Ecology; birth cohort
• Research Categories: Psychology, Developmental; Health Sciences, Public Health

Abstract

Human capital—that is the cumulative abilities, education, social skills, and mental and physical health one possesses—is increasingly recognized as key to the reduction of inequality in societies. Adverse childhood experiences have been linked to a range of human capital indicators, with the majority of research in high-income, western settings. This study aims to examine the link between adverse childhood experiences and adult human capital in a South African birth cohort and to test whether associations differ by measurement of adversity. Secondary analysis of data from the Birth to Thirty study was undertaken. Exposure data on adversity was collected prospectively throughout childhood and retrospectively at age 22. Human capital outcomes were collected at age 28. Adversity was measured as single adverse experiences, cumulative adversity, and clustered adversity. All three measurements of adversity were linked to poor human capital outcomes, with risk for poor human capital increasing with the accumulation of adversity. Adversity was clustered by quantity (low versus high) and type (household dysfunction versus abuse). Adversity in childhood was linked to a broad range of negative outcomes in young adulthood regardless of how it was measured. Nevertheless, issues of measurement are important to understand the risk mechanisms that underlie the association between adversity and poor human capital.