In more than 60 articles since 1998, internist Vincent Felitti, MD, pediatrician Robert Anda, MD, MS, and others have studied the relationship of childhood adversity and a variety of lifelong physical and emotional outcomes.1,2 Using a retrospective study design, they surveyed 17 337 adult health maintenance organization members (average age, 57 years) about crucial events during childhood and linked those events in a dose-response manner with cardiovascular disease; cancer; AIDS, and other sexually transmitted diseases; unwanted, often-high-risk pregnancies; chronic obstructive pulmonary disease; and a legacy of self-perpetuating child abuse. While it is hard to believe, many medical and child welfare professionals did not see the links among child abuse and other common social problems with poor health and premature death in adulthood.3
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