P0224 - Childhood protective factors and adult health outcomes

Background:

Childhood adversity exerts a negative dose-like response on future health and well-being outcomes. While prior studies have investigated the consequences associated with childhood trauma, few have examined the factors that help children avoid these outcomes. Identifying the protective factors that aid in the development of resilience is crucial to designing targeted interventions to improve adult health.

Objective:

To evaluate the factors that help individuals overcome adverse health outcomes associated with childhood trauma in an urban environment.

Design/

Methods:

This retrospective cohort study included adults born between 1970-1995 who grew up in or near the former Cabrini-Green (CG) Homes, a low-income, Chicago public housing development. Participants were recruited through Facebook groups, word of mouth, and prior involvement in a youth program. Subjects completed a phone or electronic survey, which included validated measures assessing childhood adversity and a variety of self-reported adult health measures. Subjects were asked about their general health status, including current smoking status, and mental health, including, hopefulness for the future and ability to cope with stress. Subjects were also asked about neighborhood and family support, neighborhood safety, and childhood youth program participation (Table 1). Simple regression models were performed to compare childhood exposure of adverse and protective factors to the adult health outcomes of interest. Multivariable logistic regression models were constructed to adjust for age, sex, and educational attainment.

Results:
Of the 334 former residents who completed the survey, only those that reported an adversity score >2 were included in the analysis (n=231). The average age was 36.4 years old (SD +/- 6.47 y). Decreased smoking rates as an adult were observed for those who reported their families cared for them as children (OR 0.32, 95% CI, 0.15-0.69, aOR 0.34, 95% CI, 0.15-0.75). Additionally, former residents who believed that people looked out for each other in the neighborhood was associated with better self-reported adult health status (aOR 0.5, 95% CI, 0.25-0.98).

Conclusion:
These findings suggest that a caring family and neighborhood connectedness are protective in mitigating childhood adversity experiences that are associated with negative adult health status. This study is limited by a small sample size and a young population. Subjects may not have yet experienced the negative health outcomes which are more prevalent with age. Current smoking status, however, may be indicative of future health problems. Devoting resources to strengthen families and communities may be a promising strategy to promote healthier adult behaviors.