Association of Positive Childhood Experiences with Health and Opportunity Outcomes in Four U.S. States.
This cross-sectional study used Behavioral Risk Factor Surveillance Survey (BRFSS) data from four states, analyzed in 2023-2024. Regression models of adult cohorts by PCE exposure and matched by demographic characteristics were used to assess associations between PCEs and current life opportunities (post-secondary education, income), health risk behaviors (moderate to heavy drinking, smoking), chronic health conditions (arthritis, asthma, cancer, chronic obstructive pulmonary disease [COPD], depression, diabetes, heart disease, kidney disease, overweight or obesity, stroke), and overall physical and mental health. Prevented fractions for the population were used to calculate the reduced proportion of total disease-specific medical spending and healthy life-years savings associated with PCEs.
Publication Information
Authors
Robert Sege, MD, PhD, FAAP*, Maria Aslam, PhD, MPH, Cora Peterson, PhD, Christina Bethell, PhD, MBA, MPH, Dina Burstein, MD, MPH*, Phyllis Holditch Niolon, PhD, Jennifer Jones, MSW, Stephanie Ettinger de Cuba, PhD, MPH, Kelsey Hannan, BA*, Elizabeth A. Swedo, MD, MPH.
*Affiliated with the HOPE National Resource Center
Journal
Publication Date
July 29, 2025
Keywords
positive childhood experiences, PCEs, adult health, adverse childhood experiences, ACEs, behavioral risk factor surveillance system, BRFS, BRFSS, medical spending costs, healthy life years, health risks, chronic conditions, physical health, mental health
Citation
Sege R. Aslam M, Peterson C, Bethell C, Burstein D, Niolon PH, Ettinger de Cuba S, Hannan K, Swedo EA,. Positive Childhood Experiences and Health and Opportunity Outcomes in Four U.S. States. JAMA Netw Open. July 29, 2025.
