Introduction: Adverse childhood experiences (ACEs) have been linked with a variety of detrimental physical and mental health outcomes later in life. Recent studies indicate that positive childhood experiences (PCEs) can protect individuals from the negative health effects of ACEs. Positive experiences and support, however, can come from a variety of sources. Our study explores whether experiencing a positive childhood environment in multiple domains is related to adult health.
Methods: We use the 2022 California Health Interview Survey adult sample (n=21,463). The 7-item PCE scale assesses support from caregivers, support from friends, school belonging, and community traditions. Overall PCE score was categorized as low (0-2 PCEs), medium (3-5 PCEs), and high (6-7 PCEs). Support within a PCE domain was defined as responding with all or most of the time to questions within that domain. Health outcomes included self-reported general health and psychological distress. Covariates included ACEs, race/ethnicity, gender, age, income, and education. We conducted logistic regression for each health outcome, with PCE domains as the predictor of interest, adjusting for all covariates and population sampling weights.
Results: PCE score is inversely associated with quality of physical and mental health in adulthood, adjusting for ACEs and covariates. Receiving support in two or more domains is associated with lower odds of fair/poor general health in adulthood, with each additional domain of support providing additional protection (2 domains: OR=0.67, 95% CI: 0.56-0.80, 3 domains: OR=0.54, 95% CI: 0.45-0.65, 4 domains: OR=0.46, 95% CI: 0.39-0.55). Each additional domain of support is associated with lower odds of psychological distress (1 domain: OR=0.61, 95% CI: 0.52-0.71, 4 domains: OR=0.22, 95%CI: 0.18-0.28). Receiving support from caregivers and a sense of belonging in high school were associated with improved physical and mental health. Participating in community traditions was inversely associated with general health, but not psychological distress.
Conclusions: PCEs buffer individuals from the negative impact of ACEs on physical and mental health. Further research is needed regarding the mechanisms of the beneficial effect of positive childhood experiences. These findings reinforce established concepts of resilience in life course epidemiology, but future studies can clarify the longitudinal and biological underpinnings of these relationships.