FIGURE 4-1 The effect of an adverse event on cumulative well-being over the life span.

Dunedin, New Zealand, which takes a life-course perspective on childhood events and later impact in life. One particular outcome, measurement of C-reactive protein, an inflammatory marker of heart disease, is increased in study participants who report child maltreatment earlier in life (Danese et al., 2007). This indicates the potential for inappropriate activation of the stress response to cause physiological changes in the body that can have effects decades later.


Corso, P., J. Mercy, T. Simon, E. Finkelstein, and T. Miller. 2007. Medical costs and productivity losses due to interpersonal and self-directed violence in the United States. American Journal of Preventive Medicine 32(6):474-482.

Danese, A., C. M. Pariante, A. Caspi, A. Taylor, and R. Poulton. 2007. Childhood maltreatment predicts adult inflammation in a life-course study. Proceedings of the National Academy of Sciences 104(4):1319-1324.

Felitti, V. J., R. F. Anda, D. Nordenberg, D. F. Williamson, A. M. Spitz, V. Edwards, M. P. Koss, and J. S. Marks. 1998. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults—The Adverse Childhood Experiences (ACE) study. American Journal of Preventive Medicine 14(4):245-258.

Geneva Declaration Secretariat. 2008. The global burden of armed violence.

Rivara, F. P., M. L. Anderson, P. Fishman, A. E. Bonomi, R. J. Reid, D. Carrell, and R. S. Thompson. 2007. Intimate partner violence and health care costs and utilization for children living in the home. Pediatrics 120(6):1270-1277.

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