Association of adverse childhood experiences with physical illness and self-rated health in the population-based Tromsø Study

Adverse childhood experiences (ACEs) are highly prevalent and associated with life-long health consequences. Here, we investigated the relationship of ACEs to adult-onset health outcomes in general population. We conducted a cross-sectional analysis using the seventh survey of the Tromsø Study, including 20 843 participants. Main exposure variables were exposure to at least one ACE, rumination related to adverse experiences, cumulative ACEs, and two clusters of ACEs, i.e. interpersonal and impersonal ACEs. Logistic and ordinal regression models were fitted to estimate the risk of adult-onset physical illness and poor self-rated health adjusted for birth year, sex, smoking, education, and income. We found that exposure to at least one ACE together with rumination was associated with increased risk of hypertension, heart failure, atrial fibrillation, diabetes, obesity, kidney disease, chronic obstructive pulmonary disease, asthma, rheumatoid arthritis, arthrosis, migraine, chronic pain, and poor self-rated health. We observed dose-effect relationships of cumulative ACEs to the aggregated risk of 14 among 16 health outcomes. While increased risk of heart failure, kidney disease, and rheumatoid arthritis was only linked to the interpersonal ACEs, increased risk of coronary artery disease was associated only with the impersonal ACEs. Our findings demonstrate that exposure to ACEs increases the risk of adult-onset physical illness and poor self-rated health in a dose-effect relationship, and rumination related to adverse experiences is associated with an aggravated risk. Inquiry into exposure to ACEs might inform about health risks. Early intervention approaches to promote positive experiences and increase resilience might alleviate life-long health burden.