A first-of-its kind research study has revealed that people who have more stressful childhood experiences face an increased risk of multiple long-term and chronic health conditions later in life.

A team from the University of Dundee’s School of Medicine have shown that each additional traumatic or stressful event experienced during childhood, such as neglect or abuse, increased a person’s odds of suffering from multiple chronic conditions later in life by nearly 13%.

The research published in BMC Medicine brought together work on adverse childhood experiences (ACEs) and multimorbidity from 25 studies involving more than 370,000 people to investigate this link.

They found that all the studies reported a “significant” link between the two.

An adverse childhood experience (ACE) is a potentially traumatic or stressful event that occurs before the age of 18 and can include a wide variety of negative experiences from parental separation and mental illness, household income challenges to emotional or physical abuse.

While Edinburgh researchers previously linked experiencing social deprivation in childhood with an increased risk of frailty among older Scots, the Dundee team has looked more broadly.

Multimorbidity encompasses having two or more long-term physical or mental health conditions, and individuals living with multimorbidity often face additional challenges managing their health.

These challenges include multiple appointments, lack of continuity of care, polypharmacy, while healthcare systems often struggle to manage the additional cost and complexity amid increased demand and rising staff pressures.

Lead author on the study Dr Dhaneesha Senaratne outlined the particular importance of understanding the combined effect of ACEs on long-term health risks given the ageing population:

“As global populations continue to age, we are seeing an increase of people with multiple long-term health conditions. 

“The natural implication is to think that is a problem that affects adults in mid or later life, but our research suggests that the origins may occur decades earlier in childhood.”

Dr Senaratne added that this link requires further exploration to better understand the direct causes of multimorbidity and potential points of intervention to improve long-term health and wellbeing.

While this study highlights the lasting influence of childhood experiences on adult health and wellbeing, the team emphasises that it does not establish whether or not ACEs are a direct cause of multimorbidity.

However, Dr Senaratne added that future work on ACEs may be beneficial in reducing the risk of long-term health conditions.

He said continuing work on trauma-informed health and care must be extended to include support in ensuring factors including ACEs are identified early:

“The increase of long-term health conditions within populations increases the complexity and cost of healthcare provision.

“If we want to address this, it may be necessary to include some strategies that also address childhood circumstances.

“There is an increased focus on developing trauma-informed models of healthcare, in which the impact of negative life experiences is incorporated into the assessment and management of long-term health conditions.

“However, identifying factors early in the cause of multimorbidity may help to mitigate the consequences of this developing healthcare crisis.”

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