How does Childhood Development affect our Health outcomes in the future?

By Freya Mizen

Health is arguably one of the most valuable aspects to the quality and experience of human life. When this is challenged it adds complexity and value in the meaning of life. To first understand what impacts health outcomes, we must first understand the difference between equity and equality, The Robert Johnson Foundation report, what we mean by social determinants of health, and the ACEs report (Robert Wood Johnson Foundation, 2003).

Equity and Equality have a difference in meaning. Traditionally in healthcare models we would strive for everyone to have equal and quality care no matter what societal and economic position that person has experienced. Instead, Robert Johnsons Foundation (RJF) suggest that we should strive for health equity. ‘Everyone has fair and just opportunity to be as healthy as possible, which requires removing obstacles to health such as poverty, discrimination and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments and health care’ (Robert Wood Johnson Foundation, 2003). Social determinants that may impact health include some of the following; Education access, Health care access and quality, Economic Stability, Social and Community context and neighbourhood/built environment.

So what might this mean if we translate this to childhood development years?

The earliest years of our life are crucial in how they set us up on paths leading towards and away from good health. Social determinant factors have been known to impact health throughout adulthood, particularly if exposed to

during developmental years. RSF highlight a cycle of opportunities or obstacles that show at every stage of life. Social and health disadvantage or advantage, accumulates over time, creating favourable opportunities or adverse obstacles to health.

Intervening in early life can interrupt a vicious cycle, transforming it into a path to health for all children and leading to a healthy and productive adult workforce. The report highlighted that improving early childhood social circumstances is one of the most effective ways for a society to achieve its health potential.

So what do we mean by Socio-economic Healthcare Inequalities?

Health inequalities are understood as health differences between groups that are avoidable, unjust, and driven by systemic factors. Researchers Link and Phelan (1995) have developed the theory of fundamental causes to explain why the association between socioeconomic status and mortality persists in society (Phelan, J,C., Link, G, B., Tehranifar, P. 2010)

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Phelan (1995) proposes that socio-economic status embodies an array of resources such as money, power, knowledge, prestige and beneficial social connections that facilitate or hinder someone’s health.

A large European study found significant health inequalities (Mackenbach et al., 2008). Showing the disparity in health outcomes between 22 countries in all parts of Europe, with data being collected according to education level and occupational class from census-based mortality studies. Deaths were classified according to cause, including common conditions such as cardiovascular disease, cancer, smoking etc. Rates of death and poorer self assessments of health were substantially higher in groups of lower socio-economic status and the magnitude of inequality between higher and lower socioeconomic status was much larger in some eastern and baltic regions. The study reported that these inequalities might be reduced by improving educational opportunities, income distribution, health-related behaviour or access to healthcare (Mackenbach, P.J., Stirbu, I., Roskam, A-J, R., et al. 2008).

Adverse Childhood Experiences (ACEs)

Furthering from socio-economic inequalities, the ACE report highlights health links between ACEs, but also positive childhood experiences (PCEs) (Daines, L.C., Hansen, D., Novella, B., et al, 2021). Prior research as well as the ACE report, highlight the physical and mental affects that these experiences have into adulthood. Viewing the developmental years as crucial to health longevity. The ACE report showed that those with 10+ ACEs are associated with an increased risk of poor health and other issues later into adulthood. The evidence linking ACEs to negative adult health, shows the relationship to; double the risk of obesity, physical inactivity, diabetes. Further triples the risk of smoking, cancer, heart disease and respiratory diseases. Four-folds, the risk of sexual risk-taking, mental health problems and problematic alcohol use, and increases the risk of harmful drug use and interpersonal and self-directed violence by seven-fold.

How does Adverse Childhood Experiences impact our pathophysiology?

Adverse Childhood Experiences (ACEs) are commonly understood through three interconnected processes: toxic stress, latent vulnerability, and epigenetic modulation (Asmussen, K., Fischer, F., Drayton, E.,et al, 2020). Together, these frameworks help explain how early adversity can shape long-term physical and mental health.

Toxic stress refers to prolonged exposure to intense adversity without adequate support. Chronic activation of the stress response can lead to excessive cortisol production, which may disrupt key psychological and biological systems. Research suggests this disruption can impair neural networks involved in immune functioning and memory, weakening children’s resistance to disease and limiting their ability to regulate stress over time.

The latent vulnerability model focuses on how maltreatment in childhood may recalibrate brain functioning in ways that increase later mental health risk. Brain-imaging studies indicate that abuse and neglect can alter systems responsible for threat detection, reward processing, and autobiographical memory. While these adaptations may help children cope in unsafe environments, they can also leave individuals more vulnerable to anxiety, depression, and other mental health difficulties in adulthood.

Epigenetic modulation explores how early experiences influence the expression of genes rather than the genes themselves. Animal studies show that low levels of nurturing caregiving can heighten stress reactivity through changes in gene expression. Although this heightened sensitivity may be adaptive in adverse environments, it can also reduce resilience to illness and stress later in life.

Reflecting on ACEs and Childhood development

Taken together, these processes highlight why early developmental years are so critical for long-term health. ACEs do not simply shape behaviour; they become biologically embedded, influencing how bodies and brains respond to the world across the lifespan. Understanding this connection offers a powerful scientific lens through which to view health inequalities -shifting the conversation from individual choices to the lasting impact of early environments, and reinforcing the importance of early intervention, prevention, and supportive caregiving systems.

References:

Asmussen, K., Fischer, F., Drayton, E. and McBride, T. (2020). Adverse childhood experiences: What we know, what we don’t know, and what should happen next. [online] Early Intervention Foundation. Available at: https://www.eif.org.uk/report/adverse-childhood-experiences-what-we-know-what-we-dont-know-and-what-should-happen-next [accessed: 1/1/2026]

Daines, C.L., Hansen, D., Novilla, M.L.B. and Crandall, A. (2021). Effects of Positive and Negative Childhood Experiences on Adult Family Health. BMC Public Health, [online] 21(1). doi:https://doi.org/10.1186/s12889-021-10732-w [accessed 1/1/2026]

Machenbach, P.J., Stirbu, I., Roskam, R.A-J., Schaap, M.M., Menvielle, G., Leinsalu, M., Kunst, E, A (2008) Socioeconomic Inequalities in health in 22 European countries [online] available at: https://pubmed.ncbi.nlm.nih.gov/18525043/  [accessed 15/6/23]

Phelan, J.C., Link, G,B., Tehranifar, P., (2010) Social Conditions as Fundamental Causes of Health Inequalities: Theory, Evidence and Policy Implications [online] available at: https://pubmed.ncbi.nlm.nih.gov/20943581/  [accessed 15/6/23]

Williams, E., Buck, D., Babalola, G. and Maguire, D. (2020). What Are Health Inequalities? [online] The King’s Fund. Available at: https://www.kingsfund.org.uk/publications/what-are-health-inequalities. [accessed: 1/1/2026]