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Published on: August 7, 2017

Cumulative adverse childhood experiences and parent-reported allergic conditions and asthma among U.S. children: A

Li-Yuan Zhang1, Mei-Ping Lu2, Jiang Wang2

  • 1Department of Allergology, First Affiliated Hospital With Nanjing Medical University.

The American Psychologist
|June 22, 2026
PubMed

Insights

Adverse childhood experiences (ACEs) significantly increase the risk of allergic diseases and asthma in children. Early life adversity, particularly in the first two years, shows the strongest links to these conditions.

Area of Science:

  • Pediatric Health
  • Environmental Health
  • Psychological Medicine

Background:

  • Allergic diseases and asthma are prevalent chronic childhood conditions.
  • The impact of adverse childhood experiences (ACEs) on allergic disease development is not fully understood at a population level.

Purpose of the Study:

  • To examine the association between ACEs and parent-reported allergic conditions and asthma in a large, nationally representative sample of U.S. children.
  • To investigate the influence of ACEs on disease severity and identify specific ACEs most strongly associated with allergic outcomes.

Main Methods:

  • Utilized pooled data from the 2016-2023 National Survey of Children's Health (N=290,599).
  • Assessed ACEs across nine domains and calculated a cumulative score.
  • Employed weighted logistic regression and restricted cubic spline models to analyze associations, including subgroup analyses by age and sociodemographics.

Main Results:

  • Exposure to four or more ACEs was linked to significantly higher odds of allergic conditions (OR=1.85) and asthma (OR=2.08) compared to no ACEs.
  • Associations were most pronounced in early childhood (ages 0-2), with ≥4 ACEs associated with 2.6-fold higher odds of allergic conditions and nearly fivefold increased odds of asthma.
  • Caregiver mental illness and racial discrimination emerged as the strongest predictors of allergic outcomes.

Conclusions:

  • Early-life adversity, including ACEs, is a critical social determinant in the development of childhood allergic diseases and asthma.
  • Findings underscore the need for early identification and intervention strategies targeting children exposed to adversity.
  • Public health initiatives should consider the impact of social determinants like ACEs on pediatric allergic health.

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