Researchers have long known that childhood trauma is linked to poorer health for women at midlife. A new study shows one important reason why.
The national study of more than 3,000 women is the first to find that those who experienced childhood trauma were more likely than others to have their first child both earlier in life and outside of marriage – and that those factors were associated with poorer health later in life.
The findings have implications for public programs to prevent teen pregnancy, said Kristi Williams, lead author of the study and professor of sociology at The Ohio State University.
These results suggest that early trauma – such as the death of a parent, physical abuse or emotional neglect – may affect young people's decision-making in ways that they can't entirely control.
It's easy to tell teens that they shouldn't have kids before marriage, but the message won't be effective if they haven't developed the capacity to do that because of trauma they experienced in childhood."
Kristi Williams, lead author
"It may be necessary to do different kinds of interventions and do them when children are younger."
Williams conducted the study with Brian Karl Finch of the University of Southern California. Their results were published today (Sept. 17, 2019) in the Journal of Health and Social Behavior.
Early childhood trauma is "shockingly" common in the United States, the researchers said in the study. One national study conducted between 1995 and 1997 found that only 36 percent of respondents reported having no such adverse childhood experiences.
Other research has shown that childhood trauma is strongly associated with multiple health risks, including cancer, diabetes, stroke and early death, Williams said. Much of this work has focused on how early adversity may have biological and neurological effects that would lead to worse health throughout life.
"But there hasn't been any attention given to how childhood adversity may affect social and developmental processes in adolescence and young adulthood – factors that we know are also strong predictors of later health," she said.
One of those factors in women is the timing and context of first birth.
Data for this new study came from the 1979 National Longitudinal Survey of Youth, which includes a representative sample of people who were aged 14 to 22 in 1979. The NLSY is run by Ohio State's Center for Human Resource Research.
Participants were interviewed every year through 1994 and once every two years since. The final sample for this study included 3,278 women.
Each participant reported whether she experienced one or more of six adverse childhood experiences before age 18: emotional neglect, physical abuse, alcoholism in the home, mental illness in the home, death of a biological parent and parental absence.
The researchers examined data on how old each participant was when she first gave birth and whether she was married, cohabiting or neither at the time.
Finally, participants rated their health at or near age 40.
Findings showed that each additional childhood trauma experienced by the participants was associated with earlier age at first birth and a greater probability for a first birth during adolescence or young adulthood compared to later (age 25 to 39).
In addition, each additional trauma was associated with a 24 percent increase in the probability of being unmarried and not cohabiting at first birth compared to the likelihood that they were married when their first child was born.
The researchers then conducted statistical tests that showed early and non-marital births were a key reason why children who experienced trauma were more likely to report poorer health at midlife.
"It is the idea of 'chains of risk' – one thing leads to another," Williams said.
"Childhood trauma leads to social and biological risks that lead to early and nonmarital birth which can lead to health problems later in life."
The findings also cast doubt on the notion that childbearing decisions are the result only of the culture in which children grow up, she said.
Some policymakers have claimed that some people don't value marriage enough, and if they were just encouraged not to have kids until after they're married, they would be better off, Williams said.
"You can promote this 'success sequence' – go to college, get a job, get married and have a child – exactly in that order. But the reason some people don't do that isn't just cultural, it is structural," Williams said.
"When people experience traumas early in life, it makes it less likely that they will be able to make those positive choices."