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Primary Submission Category: Life-course/developmental
Long Reach of Adverse Childhood Experiences on Health among Working-Aged Adults Aged 25-64 in the United States: The Role of State of Residence
Authors: Kent Jason Cheng,
Presenting Author: Kent Jason Cheng*
Abstract:
Adverse childhood experiences (ACEs) are well-established determinants of health across the life course, yet less is known about how their long-term effects vary across state policy contexts. This study examines whether the association between ACEs and adult health differs by U.S. state of residence. Data come from the 2024 Behavioral Risk Factor Surveillance System (BRFSS), restricted to adults aged 25–64 in seven states that administered the ACE module (FL, GA, HI, IA, NV, ND, VA). The outcome is self-rated physical health, dichotomized as fair/poor versus good/very good/excellent. Key predictors include ACE exposure (≥1 vs. none; ≥4 vs. <4). Logistic regression models are estimated separately by state, adjusting for age, gender, and race/ethnicity.
Preliminary results show a graded relationship between ACEs and health: adults with ≥1 ACE have 68% higher odds of reporting fair/poor health, and those with ≥4 ACEs have more than twice the odds compared to those with fewer or no ACEs. Importantly, these associations vary across states. The adverse health effects of ACEs are more pronounced in conservative-leaning states, while more liberal policy contexts appear to attenuate these relationships.
These findings suggest that the consequences of childhood adversity are not fixed but are shaped by broader policy environments. State-level differences in social protections and public health infrastructures may either exacerbate or buffer the long-term impacts of early-life disadvantage. Ongoing work will extend analyses to additional states and incorporate objective health measures.