Childhood Protective Factors and Future Adult Health Outcomes in an Urban Environment

Rachel Orbuch*, Will T. Rosenow, Sana Yousuf, Karen Sheehan

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Purpose: To evaluate protective factors that help individuals overcome adverse health outcomes associated with childhood trauma in an urban environment. Methods: This retrospective cohort study included adults born between 1970 and 1995 who grew up in the former Cabrini-Green Homes, a low-income, Chicago public housing development. Participants completed surveys asking about general health, smoking, and mental health status. Surveys included questions related to neighborhood and family support, community safety, and childhood youth program participation. Simple regression models were performed to compare childhood exposure of adverse and protective factors to adult health outcomes. Multivariable logistic regression models were constructed to adjust for age, sex, and educational attainment. Results: 334 former residents completed the survey, and only those that reported an adversity score ≥ 2 were included in the analysis (n = 248). For those individuals who reported that their families cared for them as children, they described feeling hopeful about the future (OR 2.77, 95% CI, 1.28-6.00, aOR 2.63, 95% CI, 1.21–5.75) and reported decreased smoking rates as adults (OR 0.30, 95% CI, 0.14–0.66, aOR 0.35, 95% CI, 0.16–0.78). Better self-reported adult health status was associated with residents who believed the neighborhood looked out for one another (OR 2.31, 95% CI, 1.21–4.42, aOR 2.01, 95% CI, 1.02–3.95). Conclusion: These findings suggest that a caring family and neighborhood connectedness are protective in mitigating childhood adversity. Devoting resources to strengthen families and communities is a promising strategy to promote healthier adult behaviors.

Original languageEnglish (US)
JournalJournal of Child and Adolescent Trauma
StateAccepted/In press - 2022
Externally publishedYes


  • Adverse childhood experiences
  • Childhood trauma
  • Protective factors, neighborhood
  • Race
  • Resilience

ASJC Scopus subject areas

  • Emergency Medicine
  • Critical Care and Intensive Care Medicine


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