The longitudinal association between adverse childhood experiences, childhood socioeconomic status, and lung function among middle-aged and older adults

Objectives: This study aims to investigate the association between adverse childhood experiences (ACEs), childhood socioeconomic status (SES) with lung function among general Chinese middleaged and older adults. Methods: Participants at baseline were 9052 individuals aged 45 years old and above from the China Health and Retirement Longitudinal Study (CHARLS), a population-based cohort of Chinese adults. Analyses were conducted with data from three waves (2011, 2013, and 2015). The ACEs included five threat-related indicators (i.e., physical abuse, household substance abuse, domestic violence, unsafe neighborhood, and bullying) and five deprivation-related adversities (i. e., emotional neglect, household mental illness, incarcerated household member, parental separation or divorce, and parental death). The cumulative score of threat-related and deprivationrelated ACEs was used for analysis. Lung function was assessed by peak expiratory flow (PEF). Two-level linear mixed growth models were used to evaluate the longitudinal association between and ACEs, childhood SES, and PEF. Results: Participants with more than three deprivation-related ACEs were significantly associated with lower PEF (b = -11.45 L/min, 95%CI: -18.40, -4.49) after adjusting for multiple confounding factors. Threat-related ACEs were not associated with PFF. Father's illiterate education predicted lower lung function (b = -8.49 L/min, 95%CI: -11.68, -5.31) for all middle-aged and older adults while mother's illiterate education was only significantly associated with PEF among the men (b = -9.21 L/min, 95%CI: -18.20, -0.22), and middle-aged adults (b = -7.96 L/min, 95%CI: -14.35, -1.57). Discussion: ACEs and disadvantaged childhood SES are important predictors of lower lung function during adulthood. Reducing ACEs and improving childhood SES may be beneficial for longterm health development.