Child and Adolescent Health in the United States: The Role of Adverse and Positive Childhood Experiences.

Background: Adverse childhood experiences (ACEs) have been associated with poorer health from childhood into adulthood. There has been limited prior research examining the associations between positive childhood experiences (PCEs) and health among children. Objective: The present study examines the association between PCES and child health, controlling for ACE counts, using a nationally representative sample. Participants and Setting: : The data for this study came from the 2019-2020 National Survey of Children's Health and were limited to children six years of age or older with complete demographic information and information on ACEs, PCEs, and child health (n = 46,913). Methods: Bivariate analyses between PCEs, ACEs, child/adolescent characteristics, or caregiver's characteristics and child/adolescent health were examined using Pearson's Chi-square tests, weighted to produce nationally representative distributions. Multivariable regression models were used to examine the association between selected PCEs and good health, controlling for whether a child had two or more ACEs. Results: In adjusted analyses, children who experienced any of the following PCEs had a higher odds of good health, compared to children who did not experience each type of these PCEs: after school activities (aOR 1.85; 95% CI 1.11-3.09), resilient family (aOR 2.22; 95% CI 1.45-3.41), supportive neighborhood (aOR 1.56; 95% CI 1.01-2.41), and connected caregiver (aOR 1.84; 95% CI 1.22-2.77). Conclusions: Examining and understanding PCEs and how they are associated with child health is a unique opportunity to guide more targeted policies and intervention efforts. Efforts to provide PCEs in schools, homes, and communities may help to reduce health inequities early in childhood.