Adverse Childhood Circumstances and Functional Status Throughout Adult Life.

OBJECTIVE: We studied the association of childhood adversity with adult functional status.

METHOD: With data from the Panel Study of Income Dynamics and the 2014 Childhood Retrospective Circumstances Study (1992-2013; N = 6,705; 62,885 person-years), we estimated functional status transition probabilities associated with childhood adversity, with multinomial logistic Markov models adjusted for age, sex, race/ethnicity, and education. Microsimulation then estimated functional status outcomes throughout adulthood for African American, Hispanic, and non-Hispanic White women and men.

RESULTS: Adversity was significantly associated with functional status. Of White women without adversities, 2.3% had difficulty doing activities of daily living at age 30, compared with 8.2% with high adversity; comparable results were 3.7% and 8.7% for African Americans, 0.9% and 11.5% for Hispanics (all p < .01). Patterns were similar at other ages, for men, and when adjusted for midlife health conditions and health behavior.

DISCUSSION: Childhood adversity may substantially increase functional impairment throughout adult life.