Childhood adversity and trajectories of health and quality of life in Australian children and adolescents: a latent class analysis

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PURPOSE: This study aimed to identify adverse childhood experiences (ACEs) clusters and investigate the longitudinal relationships between ACEs clusters and their effects on health and health-related quality of life (HRQoL) in Australian children and adolescents. METHODS: This study used data from the kindergarten cohort of the Longitudinal Study of Australian Children. Latent class analysis was employed to identify ACEs clusters. Generalized estimating equation (GEE) models were used to examine longitudinal associations between ACEs clusters and multiple health outcomes, including general health, mental health, obesity, and HRQoL domains. RESULTS: The study included 3,089 participants contributing 18,534 observations. Three ACEs clusters were identified: low adversity (65.8%), moderate adversity (25.5%), and high adversity (8.7%). Children in the high-adversity cluster had a higher risk of poorer mental health (IRR = 1.89, 95% CI 1.85-1.92) and suboptimal general health (OR = 1.19, 95% CI 1.17-1.22) compared with those in the low-adversity cluster. Moderate adversity was also associated with elevated risks, although of smaller magnitude. HRQoL scores across social, school, psychosocial, physical, and emotional domains were consistently lower among children exposed to higher adversity. CONCLUSION: Distinct ACEs clusters were associated with differences in health and HRQoL among Australian children and adolescents. Identifying ACEs patterns provides valuable insights for developing targeted prevention and intervention strategies aimed at mitigating the long-term health and psychosocial consequences of childhood adversity.

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