Associations Between Adverse Childhood Experiences and Family Health in Adulthood: A National Cross-Sectional Analysis

Background Whether Adverse childhood experiences (ACEs) influence family health relationships in adulthood remains an understudied area. The aim of this study was to assess the relationship between ACEs and family health and the mediating effect of socioeconomic status (SES) in adulthood. Method The 2023 PBICR was a national survey of 30,048 Chinese residents aged ≥ 18 years. We measured ACEs with the 7-item ACEs Questionnaire and family health with the Family Health Simplified Scale. Generalized linear models were used to explore the relationship between the number and type of ACEs with family health. The mediating effect of socioeconomic status (SES) in adulthood on the relationship between ACEs and family health was further examined. Result The most common type of ACEs in our study was emotional neglect (23.8%). All types of ACEs were negatively associated with family health. Of these, a history of incarceration (male: β= -4.51 (95% CI:-5.11 to -3.91; female: β= -3.18 (95% CI:-3.86 to -2.51), p < 0.0001), sexual abuse (male: β= -4.09 (95% CI:-4.53 to -3.65); female: (β= -2. 39, 95% CI:-2.80 to -1.98), P < 0.0001) and family mental illness (male: β= -3.95 (95% CI:-4.41 to -3.49); female: (β= -2.70, 95% CI:-3.15 to -2.25), P < 0.0001) were more significantly negatively associated with family health. However, there was a dose response between ACEs and family health in addition to family health resources. In addition, mediation analyses showed that the mediation proportion of SES in adulthood was only 2.15%, and ACEs participants with different residential, regional, and social characteristics had different family health performance. Conclusions The remote impact of early ACEs on family health suggests the need to integrate multidimensional interventions to reduce the long-term risk of childhood trauma and promote the health and well-being of family members. Contributions to the literature • For the first time, gender differences in family health outcomes associated with Adverse Childhood Experiences (ACEs) were quantified in a Chinese population, filling a regional research gap.