The report is based on survey responses from 144,017 adults in 25 states from 2015 to 2017. The surveys asked people about health problems as well "adverse childhood experiences" (ACEs). Examples of ACEs include abuse or neglect, violence at home, substance misuse in the home, or a relative's mental illness.
The researchers noted that the data was self-reported and the study design did not allow them to determine a causal relationship between ACES and health outcomes.
Of the adults surveyed, 60% reported at least one type of traumatic event during childhood, and more than 15% experienced four or more types of traumatic events. Women, American Indian and Alaskan Natives, and African Americans were the most likely to report experiencing four or more types of childhood traumas, the report found.
The researchers found that adults who experienced or witnessed traumatic events as a child are at higher risk of dying from at least five of the top 10 leading causes of death in the United States, such as heart disease. Those individuals also are at a higher risk of developing conditions such as asthma, cancer, depressive disorder, and diabetes, according to the report. The risk of developing such health risks was greater when people experienced multiple traumatic experiences or experienced traumatic experiences over prolonged periods of time, according to CDC.
However, CDC also noted that the negative health effects of childhood trauma can be mitigated.
In the report, CDC officials recommended programs to prevent or reduce the impact of childhood trauma, including mentoring programs, parent education, and paid family leave.
According to Anne Schuchat, principal deputy director for CDC, positive childhood relationships and environments also can help reduce the impact of negative experiences. "It might be a parent, it might be a teacher, it might be a neighbor. … That stability and nurturing will help you when you have a stress or a difficult problem [because you] have an outlet and a reliable way to process it and seek help if you need to," she said.
Overall, eliminating childhood trauma could prevent 1.9 million cases of coronary heart disease, 2.5 million cases of obesity, and 21 million cases of depression, CDC said. Preventing trauma also "could have kept up to 1.5 million students from dropping out of school," according to Schuchat.
The report is the agency's first estimate of the national impact of adverse childhood experiences, Schuchat said.
Health officials noted that the findings do not prove that childhood trauma causes certain health outcomes, but several other studies on the topic have found a similar link. Other studies also reveal negative childhood events can cause stress, which can impact body development and can lead to unhealthy behaviors in the future. "There's a lot of evidence connecting these things," according to Jim Mercy, who oversees CDC's violence prevention programs.
Separately, Dayna Long, a researcher at the UCSF Benioff Children's Hospital Oakland, said CDC's report will be "critical" to future preventive efforts. "Trauma really is a public health crisis that everybody needs to start addressing," Long said (Stobbe, Associated Press, 11/5; Chatterjee, "Shots," NPR, 11/5; Thayer, Chicago Tribune, 11/5; Hlavinka, MedPage Today, 11/5).