Childhood trauma linked to specific health risks

• Understanding the connections, the UCLA Health-led research team argues, can help customize interventions based on adverse childhood experiences, or "ACEs."
• "This is an extremely comprehensive dive into the complexities of the relationships" between certain ACEs and health, Courtney Worrell, a psychiatry researcher in at King's College London who was not involved in the study, wrote in an email.

The big picture: ACEs have become an increasingly common research topic, especially their links to poor mental health.

• ACEs include abuse, neglect, witnessing domestic abuse or other violence, as well as exposure to addiction, incarceration or mental illness in a household. Biological responses can disrupt the metabolic, neurologic, endocrine and immune systems, and are collectively referred to as a "toxic stress response."
• More than half of Americans have experienced at least one ACE, and more than one-fifth have experienced three or more during their lifetime, per the UCLA research.
• Previous research found people who experienced at least four adversities were at increased risk of cancer, heart disease, respiratory disease and mental ill health.
• However, positive adult-child relationships are associated with less depression and anxiety in young adults, regardless of whether or not they've been exposed to childhood trauma.

Yes, but: The UCLA findings in the journal Brain, Behavior, and Immunity show in greater detail how the effects of ACEs break down by sex and experience.

What they found: Researchers investigated the connection between ACEs and 25 biological markers of stress and disease and 20 major health conditions in more than 2,000 people. They further broke down these impacts by sex.

• The biological impact of stressors on the metabolic system were generally larger for females than males. Welfare status during childhood was more predictive of health problems in females, including thyroid, cardiovascular, digestive, joint and respiratory issues.
• Emotional abuse and neglect generally had larger health impacts on males, particularly for thyroid issues, blood disorders and mental and behavioral health issues. But both males and females who experienced emotional abuse exhibited higher risk of cancer and respiratory issues.

Studying the health effects of childhood experiences is part of a broader focus on "social determinants of health."

• The idea is that factors like housing, education, food security and transportation have a direct bearing on health outcomes when much of the U.S. health system still focuses on managing medical conditions after they emerge.
• Paying more attention to life experiences that lead to poor health could keep many chronic conditions from emerging in the first place and put the U.S. more on a par with other wealthy countries.
• The counter argument is that adding ACE interventions may be stretching the role of the health care system.

What we're watching: The health system doesn't systematically screen patients' stress levels or tailor stress management programs to focus on the specific biological pathways that can be disrupted, the authors write.

• Stress management tools are treated as a one-size-fits-all. Using a patient's profile to target interventions could help move the system "toward a precision medicine-based approach," they argue.
• "This would essentially call to change the way that treating physicians assess the patient on an individual basis, factoring their biological sex and their specific history of early life adversity," Worrell said.