A prospective investigation of physical health outcomes in abused and neglected children: new findings from a 30-year follow-up

Abstract

Objectives: We investigated whether abused and neglected children are at risk for negative physical health outcomes in adulthood.

Methods: Using a prospective cohort design, we matched children (aged 0-11 years) with documented cases of physical and sexual abuse and neglect from a US Midwestern county during 1967 through 1971 with nonmaltreated children. Both groups completed a medical status examination (measured health outcomes and blood tests) and interview during 2003 through 2005 (mean age=41.2 years).

Results: After adjusting for age, gender, and race, child maltreatment predicted above normal hemoglobin, lower albumin levels, poor peak airflow, and vision problems in adulthood. Physical abuse predicted malnutrition, albumin, blood urea nitrogen, and hemoglobin A1C. Neglect predicted hemoglobin A1C, albumin, poor peak airflow, and oral health and vision problems, Sexual abuse predicted hepatitis C and oral health problems. Additional controls for childhood socioeconomic status, adult socioeconomic status, unhealthy behaviors, smoking, and mental health problems play varying roles in attenuating or intensifying these relationships.

Conclusions: Child abuse and neglect affect long-term health status-increasing risk for diabetes, lung disease, malnutrition, and vision problems-and support the need for early health care prevention.

FIGURE 1—

Comparison of US population health reports of (a) excellent/very good health, (b) current smoking, and (c) obesity: Adult Health Outcomes for Abused and Neglected Children and Matched Controls, Midwestern United States, 2003–2005. Note. Assessed in middle adulthood (aged approximately 41 years). Adults with documented histories of abuse and neglect were less likely than were controls to report excellent or very good health (P < .05), as opposed to fair or poor health, and both groups were more likely than was the general population (P < .001). Abused and neglected individuals were more likely than were controls (P < .001) and the US population (P < .001) to report current smoking. Individuals with documented histories of abuse and neglect and controls were both significantly more likely to be obese than was the general US population (P < .001) but did not differ from each other.