Life Course Adversity, Premature Mortality, and Life Expectancy: Role of Life's Essential 8

Area of Science:

• Public Health
• Epidemiology
• Social Determinants of Health

Background:

• Life course adversity is a known risk factor for adverse health outcomes.
• The interplay between cumulative adversity, cardiovascular health metrics (Life's Essential 8), and premature mortality is not well understood.

Purpose of the Study:

• To investigate the association between childhood and adulthood adversity and premature mortality.
• To examine the impact of adversity on life expectancy.
• To determine if Life's Essential 8 (LE8) modifies these associations.

Main Methods:

• Utilized UK Biobank data from 148,137 participants, with LE8 data for 94,289.
• Calculated cumulative adversity scores based on reported childhood and adulthood abuse and neglect.
• Employed Cox regression and survival models to assess mortality risk and life expectancy, with LE8 stratification.

Main Results:

• Participants with two or more adversities faced a significantly higher risk of premature mortality (HRs ~1.23).
• Adversity was linked to a loss of approximately 1-1.3 years of life expectancy at age 45.
• The negative impact of adversity on mortality and life expectancy diminished with increasing LE8 levels.

Conclusions:

• Life course adversity is a significant predictor of increased premature mortality and reduced life expectancy.
• Favorable Life's Essential 8 (LE8) levels appear to buffer the detrimental effects of adversity on mortality risk.