Complex Adversity and Child Growth in Fragile Families

Background. Children living in communities with high concentrations of poverty are exposed to complex forms of adversity that can influence childhood growth. Unhealthy child growth patterns have risen sharply within high-risk communities, contributing to disparities in poorer health outcomes, including obesity and related chronic illnesses such as cardiovascular disease and Type 2 diabetes. Much of the research on the effects of adversity on child health is limited to unidimensional assessments of cumulative risk (e.g., ACEs) and does not account for the complex nature of adversity experienced by families. The aim of this study is to characterize and assess complex adversity, and specifically how singular, unidimensional measures of cumulative adversity and its hypothesized subtypes--interpersonal, family, economic, and community adversity--are associated with growth across critical stages of child development over 15 years in “Fragile Families.”

Method. Data were drawn from 4,898 U.S. mothers, fathers, and children in the Fragile Families and Child Wellbeing Study (Fragile Families) who were interviewed when children were born, and again when children were 3, 5, 9, and 15 years old. Independent variables include total adversity (25 to 37 total items per wave), which was comprised of the sum of 4 adversity subtypes: interpersonal (e.g., sexual, physical, or emotional abuse, neglect, and domestic violence; 7-8 items), family (e.g., mental health, substance use, incarceration; 8-11 items), economic (e.g., food, housing, income, bill insecurity; 9-18 items), and community (e.g., witness or victim of violence in community, 5-10 items). BMI z-score, optimal for assessing adiposity across occasions, was used to measure child growth status from ages 3 through 15. Hierarchical multiple regression was conducted in SPSS to assess how total adversity and each subtype concurrently and prospectively associated with child BMIz over the same time period.

Results. Community violence at age 5 (b = -.05, p = .02), was predictive of lower BMIz at age 9. Other subtypes and total adversity (sum of subtypes) were not predictive of BMIz at other waves.

Conclusion. Adverse childhood experiences may not increase risk of unhealthy growth patterns prior to age 15 years. Unlike prior research, we found no evidence of an association between total adversity and BMIz at 4 different sensitive ages of child development, or between the accumulation of adversity across the first 15 years of life and BMIz. However, community violence at age 5 was unexpectedly associated with lower, and not higher, BMIz approximately 4 years later. Controversial findings suggest follow-up research is needed to better understand associations and mechanisms of interaction between adverse experiences and childhood obesity risk in Fragile Families.