Having a consistent, caring adult in childhood can make a big difference for children who are victims of physical or sexual abuse. it is, Journal of Aggression, Abuse and Traumainvestigated health outcomes in more than 2,100 American Indian and Alaska Native (AI/AN) adults in the United States.
Using nationally representative data from the U.S. Behavioral Risk Factor Surveillance System from 2021 to 2023, researchers found that childhood maltreatment was strongly associated with a variety of negative physical and mental health outcomes in adulthood, including depression, arthritis, stroke, asthma, cognitive impairment, and obesity. However, the presence of a protective adult in the home, especially one who makes children feel safe at all times, greatly reduces the risk of many of these outcomes.
Our research shows that supportive relationships in early childhood are critical and can leave a lasting mark on health. Feeling protected during childhood appears to reduce the physiological and psychological damage of long-term abuse. ”
Ashley L. Quinn, first author and assistant professor; Factor Inwentash Faculty of Social Work, University of Toronto (FIFSW)
This research avoids deficit-focused narratives (those that focus on disadvantage, failure, and weakness) and focuses on resilience and protective factors within Indigenous communities, an area that has long been underrepresented in population health research.
Childhood physical or sexual abuse was common among the sample participants. More than one in four respondents reported physical abuse, and nearly one in eight reported sexual abuse. These experiences were associated with increased odds of poor mental health, chronic disease, and disability decades later. Importantly, the strength of the association between childhood physical or sexual abuse and poor health and mental health in adulthood was often reduced when researchers described whether respondents felt safe and protected by adults during childhood.
The findings were particularly striking regarding mental health outcomes. The odds of major depressive disorder were significantly lower for adults who recalled consistent protection from a trusted adult.
“Safe relationships help children regulate stress and develop healthier coping strategies,” says co-author Teagan DM Miller, a recent master’s degree graduate in social work. FIFSW, University of Toronto. “Our results suggest that these early relationship experiences continue to shape mental health into adulthood.”
Physical health outcomes also showed a significant decrease when protective adults were taken into account, and the association between abuse and conditions such as heart disease and smoking were reduced or eliminated.
“This study highlights that social relationships are biologically and clinically consequential, rather than ‘soft’ variables,” said co-author and study coordinator Shannon K. Halls. FIFSW, University of Toronto. “They should be considered central to public health prevention strategies.”
Importantly, this study emphasizes a culturally-based approach that recognizes Indigenous strengths, rather than focusing solely on risks.
“Public health policy must work with, not against, indigenous communities,” said Philip Biden. University of Texas at Arlington School of Social Work. “Interventions that strengthen the strengths of existing relationships may be particularly powerful.”
The authors argue that investing in child protection, guidance, and family support is not only morally imperative, but also essential for long-term health equity.
“Protecting children today could significantly reduce the burden of chronic disease tomorrow,” said lead author Professor Esme Fuller-Thomson. University of Toronto and director FIFSW Institute of Life Course and Aging. “Resiliency seems to increase where protection exists.”
