Childhood Adversity and Risk-taking Behaviors in Youth using National Representative Emergency Room Admission and Survey Data

Background Childhood adversity can affect propensity to risk-taking behaviors. We aim to investigate the relation between childhood adversity and risk-taking behaviors in youth using emergency room (ER) admissions and survey data. Method Using the DANLIFE study, we included 1.2 million Danes. Individuals were assigned into five groups based on childhood adversity exposure from ages 0 to 15 years. We applied survival analyses on repeated outcomes to model ER-admissions due to substances, violence and unintentional injury in the full cohort between ages 16 and 24. We applied logistic regression models to weighted survey data on frequent binge drinking, cannabis use, drug use, and unsafe sex in a nested subsample of 34,064 18 year olds from the Danish National Birth Cohort. Results The high adversity group was at highest risk of ER-admissions due to substances (HR=3.27, 95% CI [3.10, 3.46]), violence (HR=2.67, 95% CI [2.58, 2.76]) and unintentional injuries (HR=1.30, 95% CI [1.28, 1.33]). In the nested subsample, the high adversity was at highest risk of cannabis use (OR=1.59, 95% CI [1.21, 2.09]), drug use (OR=2.44, 95% CI [1.71, 3.49]) and unsafe sex (OR=1.72, 95% CI [1.34, 2.22]), but at lower risk of frequent binge drinking (OR=0.57, 95% CI [0.37, 0.87]). Conclusion These findings highlight how childhood adversity is associated with increased engagement in and harm from risk-taking behaviors. To prevent inequalities in health in youth, there is a need for interventions and policies that promote child welfare, as well as targeted support for youth with harmful behavioral patterns.