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. 2022 Feb 5;19(3):1799.
doi: 10.3390/ijerph19031799.

The Long-Term Health and Human Capital Consequences of Adverse Childhood Experiences in the Birth to Thirty Cohort: Single, Cumulative, and Clustered Adversity

Sara N Naicker  1 , Marilyn N Ahun  2   3 , Sahba Besharati  4   5 , Shane A Norris  1   6   7 , Massimiliano Orri  8 , Linda M Richter  1
Affiliations

The Long-Term Health and Human Capital Consequences of Adverse Childhood Experiences in the Birth to Thirty Cohort: Single, Cumulative, and Clustered Adversity

Sara N Naicker et al. Int J Environ Res Public Health. .

Abstract

Human capital-that is the cumulative abilities, education, social skills, and mental and physical health one possesses-is increasingly recognized as key to the reduction of inequality in societies. Adverse childhood experiences have been linked to a range of human capital indicators, with the majority of research in high-income, western settings. This study aims to examine the link between adverse childhood experiences and adult human capital in a South African birth cohort and to test whether associations differ by measurement of adversity. Secondary analysis of data from the Birth to Thirty study was undertaken. Exposure data on adversity was collected prospectively throughout childhood and retrospectively at age 22. Human capital outcomes were collected at age 28. Adversity was measured as single adverse experiences, cumulative adversity, and clustered adversity. All three measurements of adversity were linked to poor human capital outcomes, with risk for poor human capital increasing with the accumulation of adversity. Adversity was clustered by quantity (low versus high) and type (household dysfunction versus abuse). Adversity in childhood was linked to a broad range of negative outcomes in young adulthood regardless of how it was measured. Nevertheless, issues of measurement are important to understand the risk mechanisms that underlie the association between adversity and poor human capital.

Keywords: ACEs; adverse childhood experiences; birth cohort; clustered adversity; human capital.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Predicted probabilities for latent class analyses of: (a) retrospective ACEs; (b) prospective ACEs.
Figure 2
Figure 2
Significant adjusted associations (odds ratios) between single ACEs and human capital outcomes, for the total sample and disaggregated by sex.
Figure 3
Figure 3
Significant adjusted associations (odds ratios) between cumulative and clustered ACEs and human capital outcomes, for the total sample and disaggregated by sex.
See this image and copyright information in PMC

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