Dr. David A. Brent of the University of Pittsburgh School of Medicine and Western Psychiatric Institute and Clinic, and co-author Dr. Michael Silverstein of the Boston University School of Medicine said early child adversity -- defined as child maltreatment, exposure to domestic violence or living with a household member with serious mental illness -- has been linked to myriad chronic conditions associated with premature death.
In addition, exposure to adversity was linked to later smoking, substance abuse, obesity, cardiovascular disease, depression and attempted suicide.
The researchers said causal pathways between early adversity and these multiple outcomes are thought to be mediated by changes in stress responsivity. Animal models demonstrated these effects are transmitted from parent to child through epigenetic -- the effect of environment on gene expression -- mechanisms, the researchers said.
"The good news is that, if detected early enough, the impact of family adversity on child health outcomes can be reversed, or at least attenuated. For example, if maternal depression is treated to remission, the patients' children show symptomatic and functional gains," the study authors wrote in the study.
"Economic interventions that provide local employment and move parents out of poverty have been shown to be temporally related to a decreased risk for behavioral disorders in the children of the assisted families."
The economic cost -- in excess healthcare utilization, non-response to treatment, incarceration, loss of employment, decrease in productivity and disability -- weighs heavily on families burdened with adversity but ultimately is borne by society as a whole, the researchers said. In the drive to improve quality of healthcare and contain costs, the huge price tag to society of early adversity cannot be neglected, the researchers added.
The findings were published in the Journal of the American Medical Association.
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