Impact of Childhood Household Support on Depression and Self-Reported Mental and Physical Health

Background Perceived household support during childhood may have long-term effects on mental and physical health across the life course. However, the specific associations between early supportive environments and adult health outcomes remain underexplored.

We conducted a cross-sectional analysis using data from the Behavioral Risk Factor Surveillance System (BRFSS) collected between 2016 and 2023. The study included 31,233 U.S. adults aged 18 years and older who provided complete responses regarding perceived childhood household support, depression diagnosis, and the number of poor mental and physical health days. The primary exposure was self-reported childhood support, categorized as: “Never,” “A Little of the Time,” “Some of the Time,” “Most of the Time,” or “All of the Time.” Outcomes included lifetime diagnosis of depression, average monthly poor mental health days, and poor physical health days. Analyses were adjusted using inverse probability weighting and controlled for sociodemographic factors, survey weights, and state, year, and month fixed effects.

Among respondents (mean age 52.2 years; 63.4% female; 76.0% White), individuals who reported “Never” being supported during childhood were 19.4 percentage points more likely to report a depression diagnosis (95% CI: 11.6–27.2), experienced 5.33 more poor mental health days (95% CI: 3.64–7.03), and 2.77 more poor physical health days per month (95% CI: 1.23– 4.32), compared to those who reported being “Always” supported. A clear dose-response relationship was observed across all categories of household support.

Lower levels of perceived childhood household support are significantly associated with increased risk of adult depression and greater burden of poor mental and physical health. Interventions targeting early supportive environments may improve population health outcomes across the life span. Question Is perceived childhood household support associated with depression and self-reported mental and physical health outcomes in adulthood? Findings In this cross-sectional study of 31,233 U.S. adults, individuals reporting they were never supported during childhood had significantly higher depression risk and reported poorer mental and physical health days compared to those always supported, with results showing a consistent gradient across varying support levels. Meaning These findings suggest policies promoting consistent childhood household support may enhance lifelong mental and physical health outcomes. Competing Interest Statement The authors have declared no competing interest. Funding Statement Yes Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The BRFSS dataset provided de-identified data therefore, informed consent or IRB approval was not required. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data Availability All relevant data are within the manuscript and its Supporting Information files.