Dynamics of childhood adversity and poor physical and mental health in children experiencing high adversity: Findings from the DANLIFE cohort

BackgroundChildren in families navigating significant adversity often face co-occurring physical and mental health problems, which together can contribute to substantial marginalisation across the life course. These children and their families may greatly benefit from targeted interventions that facilitate the disruption of accumulating vulnerability. To facilitate these efforts, we need empirical evidence of the underlying dynamics of adversity and health problems throughout childhood.MethodsWe investigated associations between three types of childhood adversities (material deprivation, experiences of loss or threat of loss and family dynamics) and hospitalizations for mental and physical health problems across four developmental periods among 12,446 children who experienced high rates of family adversity. We used data from the Danish Life Course (DANLIFE) register-based cohort study and applied cross-lagged networks models. Hospitalizations were identified through inpatient, outpatient, and emergency hospital contacts.ResultsWe found clear evidence for the co-occurrence of childhood adversities and health problems across childhood, partially resulting from feedback loops and direct effects between different types of childhood adversities, and between physical and mental health problems. We also observed strong autoregressive effects across childhood adversity and health domains indicating vicious circles of reinforcing adversity. Conditional on high health problems in infancy, childhood adversity was not found to be associated with additional health problems throughout the rest of childhood. Child health problems were, however, positively associated with subsequent adversity across childhood. ConclusionsDynamics of childhood adversity and poor health give rise to complex reinforcing patterns of vulnerability over time. Our findings contribute to a better understanding of the emergence of vulnerability resulting from childhood adversity and poor health in children, highlighting the importance of embracing the complex nature of these emergent phenomena, both in research and intervention.