A Correlation Study Between Adverse Childhood Experiences and Health Status of Elderly People in China 

A Correlation Study Between Adverse Childhood Experiences and Health Status of Elderly People in China | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article A Correlation Study Between Adverse Childhood Experiences and Health Status of Elderly People in China Jiate Wei, Yiming Zhang, Mingshu Si, Min Chen This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7336528/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Background: The impact of adverse childhood experiences (ACEs) on physical, psychological and social health in elderly life remains to be explored. Methods: This study utilized data from the 2020 Chinese Longitudinal Aging Social Survey (CLASS). Descriptive statistics, t -tests, one-way ANOVA, and multiple linear regression analyses were conducted to assess the impact of adverse childhood experiences on physical, psychological, and social health in later life. Results: Linear regression showed that childhood experiences of parental death (for physical health: β = -0.067, P < 0.001; for psychological health: β = -0.065, P < 0.001) and starvation (for physical health: β = -0.108, P < 0.001; for psychological health: β = -0.057, P < 0.001; for social health: β = -0.132, P < 0.001) were significantly associated with poorer health status in old age. Conversely, limited access to medical resources in childhood was positively correlated with health status in later life (for physical health: β = 0.043, P < 0.001; for psychological health: β = 0.075, P < 0.001; for social health: β = 0.074, P < 0.001). Conclusions: ACEs including parental death, starvation, and limited healthcare access, have lasting effects on physical, psychological, and social well-being in older adults. Integrating medical and social support systems should be considered by policymakers to mitigate the long-term health impacts of ACEs. Adverse childhood experiences Elderly geriatric health CLASS database Social determinants of health Introduction By the end of 2024, China had 310.31 million people aged 60 and above, accounting for 22.0% of the total population. Among them, 220.23 million were aged 65 or older (15.6% of the national population), highlighting the growing challenge of population aging. Childhood, a universal stage of human development, is a critical period for physical and psychological growth, learning, and maturation[ 1 ]. As Austrian psychiatrist and psychotherapist Alfred Adler observed: “Fortunate individuals spend their lives healed and protected by their childhood, while unfortunate individuals spend their lives healing from their childhood.” This statement underscores the profound and lasting impact of childhood experiences on an individual’s well-being. Adversities encountered in childhood may lead to physical or psychological harm that is not immediately apparent but may manifest later in life. Existing research indicates that adverse childhood experiences negatively affect the immune system, endocrine function, and overall health in both the short and long term[ 2 – 8 ]. Consequently, studying childhood environments and experiences is essential for informing policies aimed at mitigating adverse health outcomes in later life. Most researches on adverse childhood experiences have focused on family stress, physical and emotional abuse, and poverty, primarily examining their effects on physical and psychological health. However, social health—an integral component of overall well-being—has received comparatively little attention. Furthermore, childhood experience is a multifaceted concept encompassing emotions, memories, perceptions, knowledge, and willpower, all of which are shaped by factors such as family structure, socioeconomic status, education, and access to healthcare. Due to this complexity, fully disentangling the interplay of these variables remains a challenge. This study utilized data from the 2020 Chinese Longitudinal Aging Social Survey (CLASS) to explore the relationship between adverse childhood experiences and health outcomes in later life. The findings aimed to provide evidence-based strategies for maintaining and improving the well-being of the elderly in the context of an aging population. Methods The Data Source This study utilized data from the Chinese Longitudinal Aging Social Survey (CLASS), which was designed and implemented by the Renmin University of China. The CLASS project was launched in 2014 and targeted Chinese citizens aged 60 and above. The baseline survey included 28 provinces across the country (excluding Hainan, Tibet, and Xinjiang). Three follow-up surveys were conducted during 2016–2017, 2018–2019, and 2020–2021, resulting in a total of 11,398 valid individual questionnaires. In this study, we extracted data from the 2020 CLASS survey which included a total number of 9,170 valid samples after excluding instances with missing values due to losses to follow-up and death. The remaining survey included questions on respondents’ demographic information, health status and relevant healthcare services received, socioeconomic conditions and psychological well-being. Additionally, this questionnaire incorporated standardized measurements including the 9-item-center for Epidemiologic Studies – Depression Scale (CES-D) for geriatric individuals, and tools to evaluate adjustment and adaptation to social development and cultural shifts. These instruments assessed participants’ psychological health status and adaptability to transitions in interpersonal relationship and social roles. Variable Designs This study considered three outcome metrics as dependent variables: physical health, psychological health, and social health. Physical health was measured through the self-rated tool in the questionnaire. Respondents were asked to assess their overall health on a 5-point Likert scale ranging from “very unhealthy” (1 point) to “very health” (5 points). Participants chose the option that best reflected their health status, which provided quantitative assessment on their physical well-being. Psychological health was evaluated with the CES-D survey which was developed by Radloff in 1977 to measure symptoms of depression. A self-reported questionnaire, the CES-D asked the respondents to rate the degree of depressive feelings based on their experience during the prior week. The CLASS project adopted the 9-item geriatric version of the CES-D, where higher total scores reflect fewer depressive symptoms and better mental health statuses. Social health was assessed in the CLASS survey using a two-dimensional, 8-item questionnaire that evaluated elderly respondents’ adaptability to social development and cultural transformations, with higher scores indicating more positive attitudes toward participating in societal transitions and better overall social health. This study incorporated three independent variables, each capturing one aspect of childhood adversities: (1) parental death, (2) experience of starvation, (3) inadequate access to medical resources. These variables were coded into a binary system (1 = experienced, 2 = did not experience). Control variables in this study included (1) comparative socioeconomic status, (2) smoking status and (3) demographic characteristics (including sex, age, educational level, marital status, body mass index and residence). The coding and descriptions of variables are listed in Table 1 . Table 1 Variable Design Variable Variable Type Coding/Range Dependent Variable Physical Health Quantitative 1–5 Psychological Health Quantitative 1–27 Social Health Quantitative 1–40 Independent Variable Parental Death During Childhood Binary Had Experience=1 Did not Experience = 2 Starvation During Childhood Binary Had Experience=1 Did not Experience=2 Inadequate Access to Medical Resources During Childhood Binary Had Experience=1 Did not Experience=2 Control Variable Sex Binary Male=1 Female=2 Age Ternary 60–69 Years=1 70–79 Years=2 80 Years and Above=3 Education Level Quaternary Illiterate=1 Primary School=2 Middle School=3 High School and Above=4 Marital Status Binary Married=1 Single # =2 Body mass index (BMI) Quaternary Underweight=1 Normal Weight=2 Overweight=3 Obese=4 Comparative Socioeconomic Status Ternary High = 1 Middle = 2 Low = 3 Smoking Status Binary Yes = 1 No = 2 Residence Binary Urban = 1 Rural = 2 # Including never married, divorced and widowed. Statistical Analysis For descriptive statistics, categorical variables were described by percentages while continuous data were described using means and standard deviations (x̅ ± s). Group comparisons were conducted using t -test and ANOVA. Multiple linear regression was developed to estimate the effects of adverse childhood experiences on health status in elderly life, with significant level set at P = 0.05. All statistical analyses were performed using SPSS 27.0. Results Characteristics of Adverse Childhood Experiences Among Older Adults Among the 9,170 survey respondents, 4,550 (49.6%) were female. Of 975 respondents who experienced parental death in childhood, 488 (50.1%) were female. 6,491 (70.8%) participants rated their economic status as comparable to others around them, while 1,640 (17.9%) reported being better off. People in different groups of age, marital status, education level and socioeconomic status had significantly different percentages of childhood parental death, inadequate access to medical resources and starvation ( P < 0.05). People in different groups of residence and body mass index (BMI) had significantly different percentages of childhood inadequate access to medical resources and starvation ( P < 0.05). Smokers had significantly higher percentage of starvation experience than non-smokers ( P < 0.001) (Table 2 ). Table 2 Childhood Adversities and Characteristics Variable Group Overall (n, %) Experienced Parental Death (n, %) χ 2 (P) Inadequate Access to Medical Resources (n, %) χ 2 (P) Experienced Starvation (n, %) χ 2 (P) Sex Male 4620 (50.4) 487 (10.5) 0.082 (0.775) 3841 (83.1) 1.882 (0.170) 3148 (68.1) 0.497 (0.481) Female 4550 (49.6) 488 (10.7) 3831 (84.2) 3069 (67.5) Age 60–69 1918 (20.9) 154 (8.0) 30.150 (<0.001 * ) 1552 (80.9) 46.474 (<0.001 * ) 1175 (61.3) 87.784 (<0.001 * ) 70–79 5122 (55.9) 537 (10.5) 4240 (82.8) 3446 (67.3) 80 and Above 2130 (23.2) 284 (13.3) 1880 (88.3) 1596 (74.9) Marital Status Married 6823 (74.4) 660 (9.7) 25.820 (<0.001 * ) 5653 (82.6) 12.861 (<0.001 * ) 4555 (66.8) 13.148 (<0.001 * ) Single # 2347 (25.6) 315 (13.4) 2019 (86.0) 1662 (70.8) Education Level Illiterate 2345 (25.6) 302 (12.9) 23.539 (<0.001 * ) 2060 (87.9) 147.090 (<0.001 * ) 1746 (74.5) 79.958 (<0.001 * ) Primary School 403 (4.4) 50 (12.4) 355 (88.1) 244 (60.5) Middle School 3357 (36.6) 350 (1.5) 2893 (86.2) 2272 (67.7) High School and Above 3065 (33.4) 273 (8.9 0) 2364 (77.1) 1955 (63.8) Residence Urban 4921 (53.7) 528 (10.6) 0.105 (0.746) 3964 (80.6) 75.225 (<0.001 * ) 3267 (66.4) 9.647 (0.002 * ) Rural 4249 (46.3) 447 (10.5) 3708 (87.3) 2950 (69.4) BMI Underweight 474 (5.2) 50 (10.5) 3.091 (0.378) 410 (86.5) 10.902 (0.012 * ) 364 (76.8) 23.724 (<0.001 * ) Normal Weight 6005 (65.5) 646 (10.8) 5029 (83.8) 4069 (67.8) Overweight 2404 (26.2) 241 (10.0) 1979 (82.3) 1580 (65.7) Obesity 287 (3.1) 38 (13.2) 254 (88.5) 204 (71.1) Socioeconomic Status High 1640 (17.9) 145 (8.8) 6.884 (0.032 * ) 1308 (79.8) 31.276 (<0.001 * ) 1068 (65.1) 9.144 (0.010 * ) Middle 6491 (70.8) 712 (11.0) 5519 (85.0) 4416 (68.0) Low 1039 (11.3) 118 (11.4) 845 (81.3) 733 (70.5) Smoking Status Yes 2587 (28.2) 269 (10.4) 0.208 (0.648) 2142 (82.8) 1.975 (0.160) 1896 (73.3) 49.791 (<0.001 * ) No 6583 (71.8) 706 (10.7) 5530 (84.0) 4321 (65.6) # Including never married, divorced and widowed. * P is statistically significant ( P < 0.05). Health Status Score and Univariate Analysis The average physical health score was 3.33 ± 0.90 in the elderly population, where t -test and ANOVA showed significant differences based on childhood parental death, insufficient medical access, starvation, sex, age, marital status, education level, BMI, socioeconomic status, and smoking status ( P < 0.05; Table 3 ). The average mental health score was 19.98 ± 3.23, with significant differences related to all the factors above plus location of residence ( P < 0.05; Table 3 ). The average social health score was 23.98 ± 4.10 and had significant differences based on childhood medical access, starvation, and the previously mentioned demographic characteristics ( P < 0.05; Table 3 ). Table 3 Physical Health, Psychological Health and Social Health in the Elderly Population with Different Characteristics Variable Group Physical Health Score ( \(\:\stackrel{-}{x}\) ±s) P Psychological Health Score ( \(\:\stackrel{-}{x}\) ±s) P Social Health Score ( \(\:\stackrel{-}{x}\) ±s) P Parental Death During Childhood Yes 3.11 ± 0.95 <0.001 b* 19.22 ± 3.07 <0.001 b* 23.81 ± 3.96 0.164 b No 3.36 ± 0.89 20.07 ± 3.24 24.00 ± 4.12 Inadequate Access to Medical Resources Yes 3.49 ± 0.93 <0.001 b* 20.78 ± 3.19 <0.001 b* 24.99 ± 4.43 <0.001 b* No 3.30 ± 0.89 19.82 ± 3.13 23.78 ± 4.01 Childhood Experience of Starvation Yes 3.25 ± 0.92 <0.001 b* 19.78 ± 3.32 <0.001 b* 23.53 ± 4.03 <0.001 b* No 3.51 ± 0.82 20.40 ± 3.40 24.93 ± 4.10 Sex Male 3.38 ± 0.89 <0.001 b* 20.14 ± 3.25 <0.001 b* 24.09 ± 4.20 0.008 b* Female 3.29 ± 0.90 19.82 ± 3.21 23.87 ± 4.00 Age 60–69 3.55 ± 0.88 <0.001 a* 20.60 ± 3.34 <0.001 c* 24.60 ± 4.37 <0.001 c* 70–79 3.35 ± 0.87 20.05 ± 3.21 23.92 ± 4.09 80 and Above 3.09 ± 0.93 19.25 ± 3.04 23.57 ± 3.81 Marital Status Married 3.39 ± 0.88 <0.001 b* 20.18 ± 3.23 <0.001 b* 24.07 ± 4.13 <0.001 b* Single # 3.18 ± 0.93 19.40 ± 3.16 23.71 ± 4.01 Education Level Illiterate 3.21 ± 0.93 <0.001 c* 19.40 ± 3.08 <0.001 c* 23.57 ± 3.65 <0.001 c* Primary School 3.19 ± 0.82 19.27 ± 3.17 24.52 ± 3.57 Middle School 3.32 ± 0.89 19.97 ± 3.22 23.62 ± 4.04 High School and Above 3.45 ± 0.88 20.53 ± 3.27 24.62 ± 4.46 Residence Urban 3.34 ± 0.89 0.384 b 20.31 ± 3.25 <0.001 b* 24.11 ± 4.22 0.001 b* Rural 3.32 ± 0.91 19.60 ± 3.17 23.83 ± 3.96 BMI Normal Weight 3.16 ± 0.98 <0.001 a* 19.98 ± 3.23 <0.001 a* 24.03 ± 4.06 <0.001 c* Underweight 3.35 ± 0.89 19.18 ± 3.13 23.58 ± 3.43 Overweight 3.35 ± 0.90 20.15 ± 3.25 24.11 ± 4.31 Obesity 3.11 ± 0.87 19.94 ± 3.08 22.44 ± 4.05 Socioeconomic Status High 3.35 ± 0.89 <0.001 c* 20.21 ± 3.16 <0.001 a* 24.17 ± 4.48 <0.001 c* Middle 3.36 ± 0.88 19.98 ± 3.24 24.00 ± 3.93 Smoking Status Low 3.14 ± 0.99 19.62 ± 3.28 23.55 ± 4.47 Yes 3.37 ± 0.90 0.006 b* 20.26 ± 3.22 <0.001 b* 23.88 ± 4.28 0.131 b No 3.32 ± 0.90 19.87 ± 3.22 24.02 ± 4.03 # Including never married, divorced and widowed. * P is statistically significant ( P < 0.05). a P values were derived from one-way ANOVA. b P values were derived from independent-samples t -test. c P values were derived from Kruskal-Wallis test. Correlation Between Adverse Childhood Experience and Health Status of Older Adults This study used multiple linear regression to explore the correlation between the health status of the elderly population and their adverse childhood experiences. Our regression model showed that after including control variables, childhood experiences of parental death (for physical health: β = -0.067, P < 0.001; for psychological health: β = -0.065, P < 0.001) and starvation (for physical health: β = -0.108, P < 0.001; for psychological health: β = -0.057, P < 0.001; for social health: β = -0.132, P < 0.001) were significantly associated with poorer health status in old age. Conversely, limited access to medical resources in childhood was positively correlated with health status in later life (for physical health: β = 0.043, P < 0.001; for psychological health: β = 0.075, P < 0.001; for social health: β = 0.074, P < 0.001) (Table 4 ). Table 4 Multiple Linear Regression Analysis of Adverse Childhood Experience and Health Status of the Elderly Population Variable Physical Health Psychological Health Social Health β P β P β P Parental Death in Childhood (“No” as reference) -0.067 <0.001 * -0.065 <0.001 * 0.002 0.965 Inadequate Access to Medical Resources in Childhood (“No” as reference) 0.043 <0.001 * 0.075 <0.001 * 0.074 <0.001 * Childhood Experience of Starvation (“No” as reference) -0.108 <0.001 * -0.057 <0.001 * -0.132 <0.001 * Sex (“Male”as reference) -0.026 <0.001 * -0.017 0.147 -0.026 0.024 * Age 60–69(Reference) 70–79 -0.090 <0.001 * -0.060 <0.001 * -0.060 <0.001 * 80 and Above -0.166 <0.001 * -0.118 <0.001 * -0.064 <0.001 * Marital Status (“Married”as reference) -0.039 <0.001 * -0.051 <0.001 * -0.008 0.438 Education Level Illiterate(Reference) Primary School 0.010 0.341 -0.017 0.121 0.039 <0.001 * Middle School 0.024 0.064 0.039 0.002 * -0.012 0.337 High School and Above 0.061 <0.001 * 0.068 <0.001 * 0.077 <0.001 * Residence (“Urban” as reference) 0.019 0.084 * -0.076 <0.001 * -0.002 0.851 BMI Normal Weight(Reference) Underweight -0.034 0.001 * -0.037 <0.001 * -0.001 0.270 Overweight -0.012 0.233 0.003 0.320 0.000 0.965 Obesity -0.039 <0.001 * -0.002 0.854 -0.062 <0.001 * Socioeconomic Status Middle(Reference) High -0.025 0.017 * 0.010 0.331 0.004 0.721 Low -0.076 <0.001 * -0.040 <0.001 * -0.033 0.001 * Smoking Status (“No” as reference) -0.018 0.108 -0.038 0.001 * 0.023 0.042 * * P is statistically significant ( P < 0.05). Discussion The average scores for physiological health, psychological health, and social health among Chinese elderly individuals are consistent with those previously reported by Si et al[ 9 ]., Li et al[ 10 ]., and Li et al[ 11 ].Multiple linear regression analysis revealed that experiencing parental death during childhood negatively impacted both the physiological and psychological health later in life. For physiological health, the role that parents serve as the cornerstone of family stability and the safety and care they provide are irreplaceable for a child’s development. The presence of parents in a home alleviates financial burdens and ensures that children receive adequate nutrition and hygiene, thereby facilitating healthy growth. Additionally, prior work has shown that parental death during childhood could impact telomere length, which in turn influence cognitive function and accelerate biological aging[ 12 ]. For psychological health, the passing of one or both parents disrupts family structure and fosters feelings of inferiority and a lack of self-confidence during adolescence[ 13 ]. Rather than an isolated event, the loss of a loved one imposes a persistent emotional burden, and the long-term psychological impact manifests in symptoms such as depression, anxiety, and a long-lasting sense of loneliness and helplessness. Our analysis showed that elderly individuals who experienced childhood starvation had worse physiological and psychological health compared to those who did not. Previous studies have suggested that experiences of food insecurity primarily might affect elderly health through diminished household income, disadvantages in education, and nutrition deficiency[ 14 ]. Lower life expectancy, higher levels of depression and poorer overall mental health have also been observed[ 15 , 16 ]. Interestingly, the surveyed population in this study lived through a period marked by severe natural disasters and widespread famine, particularly in major grain-producing regions, leading to significant food shortages. The physical and emotional toll of enduring prolonged hunger left an indelible mark on their psychological and social well-being. We also found that childhood starvation had negative effect on social health in old age. Previous studies indicated the elderly with lower childhood socioeconomic status (SES) exhibited significantly lower rates of social engagement compared to those with higher childhood SES. According to the life course theory and international consensus, childhood starvation experience serves as one of the key indicators for assessing SES. Therefore, childhood starvation may adversely affect social health in later life. A study abroad has found that social participation among the elderly is related to their socioeconomic status during childhood. The social participation rate of elderly individuals with a lower socioeconomic status during childhood is significantly lower than that of middle-aged and elderly individuals with a higher socioeconomic status[ 17 ]. According to the life course theory and the internationally accepted measurement methods for socioeconomic status, experiencing hunger during childhood is one of the indicators for measuring socioeconomic status[ 18 ]. Therefore, experiencing hunger during childhood will affect social health to some extent. It is worth noting that a positive correlation exists between experiencing limited medical resources during childhood and better physiological, psychological, and social health in old age. In other words, elderly individuals who lacked access to medical resources in childhood reported better physical health, lower depression levels, and greater psychological resilience. Since this study measures physiological health through self-rated health assessments, this suggests that older adults perceive their childhood experiences of medical scarcity as a factor that strengthened their physical resilience. Survey data showed that more than 70% of the elderly respondents considered the medical resources they received to be insufficient. This reflects the fact that this age group of individuals grew up with underdeveloped medical care, poor sanitation, and inadequate healthcare infrastructure. With inequitably distributed medical resources, lack of comprehensive health insurance coverage, and insufficient training and technical expertise among medical professionals, many resorted to traditional remedies or relied on self-healing for minor illnesses[ 19 ]. Physiologically, the process of self-recovery may have strengthened their immune system[ 20 , 21 ] Psychologically, surviving numerous illnesses without medical intervention reinforced the belief in their physical resilience, fostering a more positive and proactive attitude toward life[ 22 – 24 ]. Socially, elderly individuals with limited childhood medical resources often relied on community-based support system, which in turn boosted their social interactions and contributed to better social health[ 25 , 26 ]. Our results also indicated that being female, middle-aged or older, single, living in rural areas, having a BMI classified as underweight or obese, having poor or excellent economic conditions, and smoking were all associated with poorer health outcomes. In contrast, a higher level of education was linked to better health. These findings highlight the significant influence of personal experiences, socioeconomic status, lifestyle, and environmental factors on health outcomes[ 27 ]. Existing literature has shown that perceived poverty may have a strong negative impact on the psychological health of the elderly, consistent with our findings[ 28 ]. Specifically, elderly individuals with poorer economic conditions experienced more severe mental health challenges. Additionally, education level served as a mediating variable in self-rated health among middle-aged and elderly individuals[ 29 ]. Study by Wang et al. further suggested that a higher education level facilitates social engagement and adaptation in old age[ 30 ]. These findings underscore the positive influence of education on physiological and social health, mitigating the adverse effects of adverse childhood experiences on later-life health. Overall, the negative impact of adverse childhood experiences on health is profound, enduring, and difficult to erase[ 31 ]. While existing literature on elderly health predominantly investigated the relationship between current behaviors and health status, this study explored the link between health and childhood experience by retrospectively examining events such as starvation, parental loss, and inadequate medical resources. By primarily focusing on the childhood stage, the large sample size of 9.170 enrollments provides robust insights into how these experiences influence an individual’s health in later life stages, thereby contributing to the cumulative knowledge on the interplay between early-life adversities and life quality in the elderly. This study is also bound by several limitations. First, the survey used self-reported data to assess physical health. While self-reporting has been a standard method in literature, the respondent’s subjective feelings of well-being might divert from an objective medical assessment[ 32 ]. Secondly, selection bias could contribute to the underestimate of adverse childhood experiences’ impact on health outcome, as many individuals with such experiences might have passed away, leaving a survival population that was potentially healthier and more resilient[ 33 ]. Multi-wave longitudinal data and the application of inverse probability weighting methods to control for mortality selection could mitigate the effects of this selection bias[ 34 ]. Conclusions In conclusion, we found childhood parental death and starvation were associated with poorer health outcomes, whereas limited childhood medical resources were associate with better overall health. Therefore, while past negative experiences cannot be altered, targeted interventions can help mitigate their impact. Future efforts should focus on promoting physiological health through preventive measures, fostering psychological well-being by creating supportive environments, and enhancing social health through increased community participation and support systems. Additionally, it is crucial to foster resilience in children help them learn coping skills, develop an optimistic outlook when navigating adversity, managing stress, and overcoming challenges. Ultimately, health outcomes are shaped across the entire life course, with childhood experiences as pivotal moments that continue to shape a person’s adulthood and old age. Investment into child protection measures will have a long-lasting impact on public health. Declarations Acknowledgments We thank the support from Fujian Research Association for Medical and Health System Reform. Authors’ contributions JW and YZ designed the study. MS managed and analyzed the data. JW and MS prepared the first draft. JW, YZ, and MS reviewed and edited the manuscript, with comments from JW, YZ, MS, and MC. All authors were involved in revising the paper, and MS had full access to the data and gave final approval of the submitted versions. Funding This work was supported by National Social Science Foundation of China（23BSH096）; 2021 Basic Theoretical Research Project of Philosophy and Social Sciences Disciplines Guided by Marxism in Universities (JSZM2021026) and Research Project of Fujian Association for Science and Technology Innovation Think Tank in 2024 (FJKY-2024XKB010). Data availability The data source of this study was a publicly available database, China Longitudinal Aging Social Survey, which was hosted by the China Survey and Data Center, Renmin University of China. The data are available at http://class.ruc.edu.cn/. Ethics approval and consent to participate Not applicable. Consent for publication The authors give consent for publication of this paper in BMC Public Health. Competing interests The authors declare no competing interests. Author details 1 Capital Medical University, Beijing Friendship Hospital, Beijing, China 2 UMass Chan Medical School, Worcester, MA 3 School of Health Management, Fujian Medical University, Fuzhou, Fujian, China 350122 4 Health and Elderly Care Professional Committee of Fujian Research Association for Medical and Health System, Fuzhou, Fujian, China 350122 5 Fujian Research Association for Medical and Health System Reform, Fuzhou, Fujian, China 350122 # Contributed equally. *Corresponding Author: Mingshu Si, PhD, School of Health Management, Fujian Medical University, No.1 Xuefu North Road, Minhou University District, Fuzhou, Fujian, China 350122 E-mail： [email protected] ; ORCID iD: 0009-0003-0929-261X References National Bureau of Statistics. Press Conference on the Operation of the National Economy in 2024. https://baijiahao.baidu.com/s?id=1821461118997647177&wfr=spider&for=pc. 2025. 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Yamakita M, Kanamori S, Kondo N, Ashida T, Fujiwara T, Tsuji T, et al. Association between childhood socioeconomic position and sports group participation among Japanese older adults: A cross-sectional study from the JAGES 2010 survey. Prev Med Rep. 2020;18. https://doi.org/10.1016/j.pmedr.2020.101065. Huang Xiaotong, Wang Qiong, Liu Chen，et al. A Path Analysis of the Effect of Childhood Socioeconomic Status on Cognitive Function in Middle-aged and Older Adults. Chinese General Practice. 2024;27:322-327，334. Liu Yuanli. The Chinese Road to achieving universal access to basic healthcare . Administrative Management Reform. 2021;14–22. Yang Lei. Childhood adversity and the development trajectory of chronic diseases in later years. Social Development Research. 2023;10:62-82，243. Liu Xin’an, Jia Yicong, Wang Liping. Understanding the Principles of Traditional Chinese Medicine through the Self-healing System Maintained by the Interaction of Neuroendocrine Immune Metabolic Networks. Chinese Science Foundation. 2024; 38:492–500. Yuan M, Qin F, Xu C, Fang Y. Heterogeneous adverse childhood experiences and cognitive function in an elderly Chinese population: A cohort study. BMJ Open. 2022;12. https://doi.org/10.1136/bmjopen-2021-060477. Liu Ruiping, Li Jianxin. The multiple impacts of childhood adversity on the health of middle-aged and elderly people in China: single, cumulative, and combined effects. Journal of Yunnan University for Nationalities (Philosophy and Social Sciences Edition). 2021; 38:57–70. Ma N, Ji X, Shi Y, Wang Q, Wu J, Cui X, et al. Adverse childhood experiences and mental health disorder in China: A nationwide study from CHARLS. J Affect Disord. 2024;355. https://doi.org/10.1016/j.jad.2024.03.110. Boccaccio DE, Cenzer I, Covinsky KE. Life satisfaction among older adults with impairment in activities of daily living. Age Ageing. 2021;50. https://doi.org/10.1093/ageing/afab172. Lin L, Cao B, Chen W, Li J, Zhang Y, Guo VY. Association of Adverse Childhood Experiences and Social Isolation with Later-Life Cognitive Function among Adults in China. JAMA Netw Open. 2022;5. https://doi.org/10.1001/jamanetworkopen.2022.41714. Mao Ping, Wang Lulu, Tan Minghui et al. Mental health status of adolescents with adverse childhood experience and the influencing factors. Cent South Univ (Med Sci). 2021; 46:1298–305. Li Y, Chen T, Li Q, Jiang L. The Impact of Subjective Poverty on the Mental Health of the Elderly in China: The Mediating Role of Social Capital. Int J Environ Res Public Health. 2023;20. https://doi.org/10.3390/ijerph20176672. Wang Qiong, Li Linchao, Liu Chen et al. Intermediary path analysis of the impact of childhood health on middle － aged and elderly health from the perspective of life course. Modern Preventive Medicine. 2022; 49:2795–801. Wang Lihua, Gao Liang. The current social health status and influencing factors of elderly people in urban communities. Chinese Journal of Gerontology. 2018; 38:197–8. Guo Junqian, Hao Juan. The Influence of Unfavorable Chiwheod Experiences on Health Status of the Elderly. Scientific Research on Aging. 2020; 8:29–40. Du Xinyuan, Fang Ya, Zeng Yanbing. Study on Influence of Socioeconomic Position on Health Status of the Elderly in China from the Perspective of Life Course. Med Soc (Berkeley). 2023; 36:19-24,43. Hayward MD, Gorman BK. The long arm of childhood: The influence of early-life social conditions of men’s mortality. Demography. 2004;41. https://doi.org/10.1353/dem.2004.0005. Liu Ruiping, Li Jianxin. The impact of adverse childhood experiences on the health of middle-aged and elderly people: a study based on selective treatment of death. Journal of Yunnan Minzu University (Philosophy and Social Sciences Edition). 2022; 39:66–75. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7336528","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":508354132,"identity":"ea2956f7-debc-4bc8-a1c3-d137a5f7c190","order_by":0,"name":"Jiate Wei","email":"","orcid":"","institution":"Capital Medical University, Beijing Friendship Hospital","correspondingAuthor":false,"prefix":"","firstName":"Jiate","middleName":"","lastName":"Wei","suffix":""},{"id":508354136,"identity":"d97a930c-0a02-4356-b093-f221dcff55bd","order_by":1,"name":"Yiming Zhang","email":"","orcid":"","institution":"University of Massachusetts Chan Medical School","correspondingAuthor":false,"prefix":"","firstName":"Yiming","middleName":"","lastName":"Zhang","suffix":""},{"id":508354137,"identity":"9f721f01-ac44-49f1-8839-ef37155c0157","order_by":2,"name":"Mingshu Si","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA4UlEQVRIie3PvwuCQBTA8RcH53LhKgj1Lzw5yATBf0UJbpIQWhuMoEma7b9wag6O/BuEGwpcG4IgGqIftBaKW8N9pje8L7wHoGl/CAEI+UzDWh7P6A86JCCEkyeCd0litNlZRq2Jayxrnsy3gQk75D6SEAy5L5oSLyv5JC9VtFmkYR0jnQITomo8rIqJZFSFKGHHY2QzsNioOTmc3slDBUHZS+0xWlHamlSMTPor1SsYARsQ2xMvE5z31yrKK0qdDENO235xDVnb7KoCMzcvx9v9OTANWTYm32i3dU3TNO2XF1d2R9x/6vYSAAAAAElFTkSuQmCC","orcid":"","institution":"Fujian Medical University","correspondingAuthor":true,"prefix":"","firstName":"Mingshu","middleName":"","lastName":"Si","suffix":""},{"id":508354138,"identity":"2672ddd2-c53b-472f-8e40-3e35a01f5d2d","order_by":3,"name":"Min Chen","email":"","orcid":"","institution":"Fujian Medical University","correspondingAuthor":false,"prefix":"","firstName":"Min","middleName":"","lastName":"Chen","suffix":""}],"badges":[],"createdAt":"2025-08-10 03:23:08","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7336528/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7336528/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":90396184,"identity":"9949aaba-f4ff-4f8c-bcea-114483a0410a","added_by":"auto","created_at":"2025-09-02 09:25:58","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1259981,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7336528/v1/a534317b-d5c3-4916-9547-c934ce0dc6af.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"A Correlation Study Between Adverse Childhood Experiences and Health Status of Elderly People in China ","fulltext":[{"header":"Introduction","content":"\u003cp\u003eBy the end of 2024, China had 310.31\u0026nbsp;million people aged 60 and above, accounting for 22.0% of the total population. Among them, 220.23\u0026nbsp;million were aged 65 or older (15.6% of the national population), highlighting the growing challenge of population aging. Childhood, a universal stage of human development, is a critical period for physical and psychological growth, learning, and maturation[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. As Austrian psychiatrist and psychotherapist Alfred Adler observed: \u0026ldquo;Fortunate individuals spend their lives healed and protected by their childhood, while unfortunate individuals spend their lives healing from their childhood.\u0026rdquo; This statement underscores the profound and lasting impact of childhood experiences on an individual\u0026rsquo;s well-being. Adversities encountered in childhood may lead to physical or psychological harm that is not immediately apparent but may manifest later in life.\u003c/p\u003e\u003cp\u003eExisting research indicates that adverse childhood experiences negatively affect the immune system, endocrine function, and overall health in both the short and long term[\u003cspan additionalcitationids=\"CR3 CR4 CR5 CR6 CR7\" citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Consequently, studying childhood environments and experiences is essential for informing policies aimed at mitigating adverse health outcomes in later life. Most researches on adverse childhood experiences have focused on family stress, physical and emotional abuse, and poverty, primarily examining their effects on physical and psychological health. However, social health\u0026mdash;an integral component of overall well-being\u0026mdash;has received comparatively little attention.\u003c/p\u003e\u003cp\u003eFurthermore, childhood experience is a multifaceted concept encompassing emotions, memories, perceptions, knowledge, and willpower, all of which are shaped by factors such as family structure, socioeconomic status, education, and access to healthcare. Due to this complexity, fully disentangling the interplay of these variables remains a challenge. This study utilized data from the 2020 Chinese Longitudinal Aging Social Survey (CLASS) to explore the relationship between adverse childhood experiences and health outcomes in later life. The findings aimed to provide evidence-based strategies for maintaining and improving the well-being of the elderly in the context of an aging population.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eThe Data Source\u003c/h2\u003e\u003cp\u003eThis study utilized data from the Chinese Longitudinal Aging Social Survey (CLASS), which was designed and implemented by the Renmin University of China. The CLASS project was launched in 2014 and targeted Chinese citizens aged 60 and above. The baseline survey included 28 provinces across the country (excluding Hainan, Tibet, and Xinjiang). Three follow-up surveys were conducted during 2016\u0026ndash;2017, 2018\u0026ndash;2019, and 2020\u0026ndash;2021, resulting in a total of 11,398 valid individual questionnaires. In this study, we extracted data from the 2020 CLASS survey which included a total number of 9,170 valid samples after excluding instances with missing values due to losses to follow-up and death. The remaining survey included questions on respondents\u0026rsquo; demographic information, health status and relevant healthcare services received, socioeconomic conditions and psychological well-being. Additionally, this questionnaire incorporated standardized measurements including the 9-item-center for Epidemiologic Studies \u0026ndash; Depression Scale (CES-D) for geriatric individuals, and tools to evaluate adjustment and adaptation to social development and cultural shifts. These instruments assessed participants\u0026rsquo; psychological health status and adaptability to transitions in interpersonal relationship and social roles.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eVariable Designs\u003c/h3\u003e\n\u003cp\u003eThis study considered three outcome metrics as dependent variables: physical health, psychological health, and social health.\u003c/p\u003e\u003cp\u003ePhysical health was measured through the self-rated tool in the questionnaire. Respondents were asked to assess their overall health on a 5-point Likert scale ranging from \u0026ldquo;very unhealthy\u0026rdquo; (1 point) to \u0026ldquo;very health\u0026rdquo; (5 points). Participants chose the option that best reflected their health status, which provided quantitative assessment on their physical well-being.\u003c/p\u003e\u003cp\u003ePsychological health was evaluated with the CES-D survey which was developed by Radloff in 1977 to measure symptoms of depression. A self-reported questionnaire, the CES-D asked the respondents to rate the degree of depressive feelings based on their experience during the prior week. The CLASS project adopted the 9-item geriatric version of the CES-D, where higher total scores reflect fewer depressive symptoms and better mental health statuses.\u003c/p\u003e\u003cp\u003eSocial health was assessed in the CLASS survey using a two-dimensional, 8-item questionnaire that evaluated elderly respondents\u0026rsquo; adaptability to social development and cultural transformations, with higher scores indicating more positive attitudes toward participating in societal transitions and better overall social health.\u003c/p\u003e\u003cp\u003eThis study incorporated three independent variables, each capturing one aspect of childhood adversities: (1) parental death, (2) experience of starvation, (3) inadequate access to medical resources. These variables were coded into a binary system (1\u0026thinsp;=\u0026thinsp;experienced, 2\u0026thinsp;=\u0026thinsp;did not experience).\u003c/p\u003e\u003cp\u003eControl variables in this study included (1) comparative socioeconomic status, (2) smoking status and (3) demographic characteristics (including sex, age, educational level, marital status, body mass index and residence). The coding and descriptions of variables are listed in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eVariable Design\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eVariable Type\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eCoding/Range\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDependent Variable\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePhysical Health\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eQuantitative\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1\u0026ndash;5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePsychological Health\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eQuantitative\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1\u0026ndash;27\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSocial Health\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eQuantitative\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1\u0026ndash;40\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003eIndependent Variable\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eParental Death During Childhood\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eBinary\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eHad Experience=1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eDid not Experience\u0026thinsp;=\u0026thinsp;2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStarvation During Childhood\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eBinary\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eHad Experience=1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eDid not Experience=2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eInadequate Access to Medical Resources During Childhood\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eBinary\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eHad Experience=1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eDid not Experience=2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"19\" rowspan=\"20\"\u003e\u003cp\u003eControl Variable\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSex\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eBinary\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMale=1\u003c/p\u003e\u003cp\u003eFemale=2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eTernary\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e60\u0026ndash;69 Years=1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e70\u0026ndash;79 Years=2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e80 Years and Above=3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEducation Level\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eQuaternary\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eIlliterate=1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePrimary School=2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMiddle School=3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eHigh School and Above=4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMarital Status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eBinary\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMarried=1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSingle\u003csup\u003e#\u003c/sup\u003e=2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBody mass index (BMI)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eQuaternary\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eUnderweight=1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eNormal Weight=2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eOverweight=3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eObese=4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eComparative Socioeconomic Status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eTernary\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eHigh\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMiddle\u0026thinsp;=\u0026thinsp;2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eLow\u0026thinsp;=\u0026thinsp;3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSmoking Status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eBinary\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eYes\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eNo\u0026thinsp;=\u0026thinsp;2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eResidence\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eBinary\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eUrban\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eRural\u0026thinsp;=\u0026thinsp;2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003csup\u003e#\u003c/sup\u003e Including never married, divorced and widowed.\u003c/p\u003e\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\u003ch2\u003eStatistical Analysis\u003c/h2\u003e\u003cp\u003eFor descriptive statistics, categorical variables were described by percentages while continuous data were described using means and standard deviations (x̅ \u0026plusmn; s). Group comparisons were conducted using \u003cem\u003et\u003c/em\u003e-test and ANOVA. Multiple linear regression was developed to estimate the effects of adverse childhood experiences on health status in elderly life, with significant level set at \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.05. All statistical analyses were performed using SPSS 27.0.\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\u003ch2\u003eCharacteristics of Adverse Childhood Experiences Among Older Adults\u003c/h2\u003e\u003cp\u003eAmong the 9,170 survey respondents, 4,550 (49.6%) were female. Of 975 respondents who experienced parental death in childhood, 488 (50.1%) were female. 6,491 (70.8%) participants rated their economic status as comparable to others around them, while 1,640 (17.9%) reported being better off. People in different groups of age, marital status, education level and socioeconomic status had significantly different percentages of childhood parental death, inadequate access to medical resources and starvation (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). People in different groups of residence and body mass index (BMI) had significantly different percentages of childhood inadequate access to medical resources and starvation (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Smokers had significantly higher percentage of starvation experience than non-smokers (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eChildhood Adversities and Characteristics\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"9\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGroup\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eOverall\u003c/p\u003e\u003cp\u003e(n, %)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eExperienced Parental Death\u003c/p\u003e\u003cp\u003e(n, %)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e \u003cem\u003e(P)\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eInadequate Access to Medical Resources\u003c/p\u003e\u003cp\u003e(n, %)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e \u003cem\u003e(P)\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eExperienced Starvation\u003c/p\u003e\u003cp\u003e(n, %)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e \u003cem\u003e(P)\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eSex\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4620\u003c/p\u003e\u003cp\u003e(50.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e487\u003c/p\u003e\u003cp\u003e(10.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.082\u003c/p\u003e\u003cp\u003e(0.775)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e3841\u003c/p\u003e\u003cp\u003e(83.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1.882\u003c/p\u003e\u003cp\u003e(0.170)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e3148\u003c/p\u003e\u003cp\u003e(68.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.497\u003c/p\u003e\u003cp\u003e(0.481)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4550\u003c/p\u003e\u003cp\u003e(49.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e488\u003c/p\u003e\u003cp\u003e(10.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e3831\u003c/p\u003e\u003cp\u003e(84.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e3069\u003c/p\u003e\u003cp\u003e(67.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e60\u0026ndash;69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1918\u003c/p\u003e\u003cp\u003e(20.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e154\u003c/p\u003e\u003cp\u003e(8.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e30.150\u003c/p\u003e\u003cp\u003e(\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1552\u003c/p\u003e\u003cp\u003e(80.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e46.474\u003c/p\u003e\u003cp\u003e(\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1175\u003c/p\u003e\u003cp\u003e(61.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e87.784\u003c/p\u003e\u003cp\u003e(\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e70\u0026ndash;79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e5122\u003c/p\u003e\u003cp\u003e(55.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e537\u003c/p\u003e\u003cp\u003e(10.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e4240\u003c/p\u003e\u003cp\u003e(82.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e3446\u003c/p\u003e\u003cp\u003e(67.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e80 and Above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2130\u003c/p\u003e\u003cp\u003e(23.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e284\u003c/p\u003e\u003cp\u003e(13.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1880\u003c/p\u003e\u003cp\u003e(88.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1596\u003c/p\u003e\u003cp\u003e(74.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarital Status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6823\u003c/p\u003e\u003cp\u003e(74.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e660\u003c/p\u003e\u003cp\u003e(9.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e25.820\u003c/p\u003e\u003cp\u003e(\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e5653\u003c/p\u003e\u003cp\u003e(82.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e12.861\u003c/p\u003e\u003cp\u003e(\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e4555\u003c/p\u003e\u003cp\u003e(66.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e13.148\u003c/p\u003e\u003cp\u003e(\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSingle\u003csup\u003e#\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2347\u003c/p\u003e\u003cp\u003e(25.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e315\u003c/p\u003e\u003cp\u003e(13.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2019\u003c/p\u003e\u003cp\u003e(86.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1662\u003c/p\u003e\u003cp\u003e(70.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEducation Level\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIlliterate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2345\u003c/p\u003e\u003cp\u003e(25.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e302\u003c/p\u003e\u003cp\u003e(12.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e23.539\u003c/p\u003e\u003cp\u003e(\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2060\u003c/p\u003e\u003cp\u003e(87.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e147.090\u003c/p\u003e\u003cp\u003e(\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1746\u003c/p\u003e\u003cp\u003e(74.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e79.958\u003c/p\u003e\u003cp\u003e(\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePrimary School\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e403\u003c/p\u003e\u003cp\u003e(4.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e50\u003c/p\u003e\u003cp\u003e(12.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e355\u003c/p\u003e\u003cp\u003e(88.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e244\u003c/p\u003e\u003cp\u003e(60.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMiddle School\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3357\u003c/p\u003e\u003cp\u003e(36.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e350\u003c/p\u003e\u003cp\u003e(1.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2893\u003c/p\u003e\u003cp\u003e(86.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e2272\u003c/p\u003e\u003cp\u003e(67.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHigh School and Above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3065\u003c/p\u003e\u003cp\u003e(33.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e273\u003c/p\u003e\u003cp\u003e(8.9 0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2364\u003c/p\u003e\u003cp\u003e(77.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1955\u003c/p\u003e\u003cp\u003e(63.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eResidence\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUrban\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4921\u003c/p\u003e\u003cp\u003e(53.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e528\u003c/p\u003e\u003cp\u003e(10.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.105\u003c/p\u003e\u003cp\u003e(0.746)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e3964\u003c/p\u003e\u003cp\u003e(80.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e75.225\u003c/p\u003e\u003cp\u003e(\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e3267\u003c/p\u003e\u003cp\u003e(66.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e9.647\u003c/p\u003e\u003cp\u003e(0.002\u003csup\u003e*\u003c/sup\u003e)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRural\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4249\u003c/p\u003e\u003cp\u003e(46.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e447\u003c/p\u003e\u003cp\u003e(10.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e3708\u003c/p\u003e\u003cp\u003e(87.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e2950\u003c/p\u003e\u003cp\u003e(69.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBMI\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUnderweight\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e474\u003c/p\u003e\u003cp\u003e(5.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e50\u003c/p\u003e\u003cp\u003e(10.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e3.091\u003c/p\u003e\u003cp\u003e(0.378)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e410\u003c/p\u003e\u003cp\u003e(86.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e10.902\u003c/p\u003e\u003cp\u003e(0.012\u003csup\u003e*\u003c/sup\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e364\u003c/p\u003e\u003cp\u003e(76.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e23.724\u003c/p\u003e\u003cp\u003e(\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNormal Weight\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6005\u003c/p\u003e\u003cp\u003e(65.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e646\u003c/p\u003e\u003cp\u003e(10.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e5029\u003c/p\u003e\u003cp\u003e(83.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e4069\u003c/p\u003e\u003cp\u003e(67.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOverweight\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2404\u003c/p\u003e\u003cp\u003e(26.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e241\u003c/p\u003e\u003cp\u003e(10.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1979\u003c/p\u003e\u003cp\u003e(82.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1580\u003c/p\u003e\u003cp\u003e(65.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eObesity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e287\u003c/p\u003e\u003cp\u003e(3.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e38\u003c/p\u003e\u003cp\u003e(13.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e254\u003c/p\u003e\u003cp\u003e(88.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e204\u003c/p\u003e\u003cp\u003e(71.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSocioeconomic Status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHigh\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1640\u003c/p\u003e\u003cp\u003e(17.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e145\u003c/p\u003e\u003cp\u003e(8.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e6.884\u003c/p\u003e\u003cp\u003e(0.032\u003csup\u003e*\u003c/sup\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1308\u003c/p\u003e\u003cp\u003e(79.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e31.276\u003c/p\u003e\u003cp\u003e(\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1068\u003c/p\u003e\u003cp\u003e(65.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e9.144\u003c/p\u003e\u003cp\u003e(0.010\u003csup\u003e*\u003c/sup\u003e)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMiddle\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6491\u003c/p\u003e\u003cp\u003e(70.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e712\u003c/p\u003e\u003cp\u003e(11.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e5519\u003c/p\u003e\u003cp\u003e(85.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e4416\u003c/p\u003e\u003cp\u003e(68.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLow\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1039\u003c/p\u003e\u003cp\u003e(11.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e118\u003c/p\u003e\u003cp\u003e(11.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e845\u003c/p\u003e\u003cp\u003e(81.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e733\u003c/p\u003e\u003cp\u003e(70.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSmoking Status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2587\u003c/p\u003e\u003cp\u003e(28.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e269\u003c/p\u003e\u003cp\u003e(10.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.208\u003c/p\u003e\u003cp\u003e(0.648)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2142\u003c/p\u003e\u003cp\u003e(82.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1.975\u003c/p\u003e\u003cp\u003e(0.160)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1896\u003c/p\u003e\u003cp\u003e(73.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e49.791\u003c/p\u003e\u003cp\u003e(\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6583\u003c/p\u003e\u003cp\u003e(71.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e706\u003c/p\u003e\u003cp\u003e(10.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e5530\u003c/p\u003e\u003cp\u003e(84.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e4321\u003c/p\u003e\u003cp\u003e(65.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003csup\u003e#\u003c/sup\u003e Including never married, divorced and widowed.\u003c/p\u003e\u003cp\u003e\u003csup\u003e*\u003c/sup\u003e \u003cem\u003eP\u003c/em\u003e is statistically significant (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eHealth Status Score and Univariate Analysis\u003c/h2\u003e\u003cp\u003eThe average physical health score was 3.33\u0026thinsp;\u0026plusmn;\u0026thinsp;0.90 in the elderly population, where \u003cem\u003et\u003c/em\u003e-test and ANOVA showed significant differences based on childhood parental death, insufficient medical access, starvation, sex, age, marital status, education level, BMI, socioeconomic status, and smoking status (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05; Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). The average mental health score was 19.98\u0026thinsp;\u0026plusmn;\u0026thinsp;3.23, with significant differences related to all the factors above plus location of residence (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05; Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). The average social health score was 23.98\u0026thinsp;\u0026plusmn;\u0026thinsp;4.10 and had significant differences based on childhood medical access, starvation, and the previously mentioned demographic characteristics (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05; Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003ePhysical Health, Psychological Health and Social Health in the Elderly Population with Different Characteristics\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"8\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGroup\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePhysical Health Score\u003c/p\u003e\u003cp\u003e(\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:\\stackrel{-}{x}\\)\u003c/span\u003e\u003c/span\u003e\u0026plusmn;s)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePsychological Health Score\u003c/p\u003e\u003cp\u003e(\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:\\stackrel{-}{x}\\)\u003c/span\u003e\u003c/span\u003e\u0026plusmn;s)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eSocial Health Score\u003c/p\u003e\u003cp\u003e(\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:\\stackrel{-}{x}\\)\u003c/span\u003e\u003c/span\u003e\u0026plusmn;s)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eParental Death During Childhood\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.11\u0026thinsp;\u0026plusmn;\u0026thinsp;0.95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003eb*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e19.22\u0026thinsp;\u0026plusmn;\u0026thinsp;3.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003eb*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e\u003cp\u003e23.81\u0026thinsp;\u0026plusmn;\u0026thinsp;3.96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.164\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.36\u0026thinsp;\u0026plusmn;\u0026thinsp;0.89\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e20.07\u0026thinsp;\u0026plusmn;\u0026thinsp;3.24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e\u003cp\u003e24.00\u0026thinsp;\u0026plusmn;\u0026thinsp;4.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eInadequate Access to Medical Resources\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.49\u0026thinsp;\u0026plusmn;\u0026thinsp;0.93\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003eb*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e20.78\u0026thinsp;\u0026plusmn;\u0026thinsp;3.19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003eb*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e\u003cp\u003e24.99\u0026thinsp;\u0026plusmn;\u0026thinsp;4.43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003eb*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.30\u0026thinsp;\u0026plusmn;\u0026thinsp;0.89\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e19.82\u0026thinsp;\u0026plusmn;\u0026thinsp;3.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e\u003cp\u003e23.78\u0026thinsp;\u0026plusmn;\u0026thinsp;4.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eChildhood Experience of Starvation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.25\u0026thinsp;\u0026plusmn;\u0026thinsp;0.92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003eb*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e19.78\u0026thinsp;\u0026plusmn;\u0026thinsp;3.32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003eb*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e\u003cp\u003e23.53\u0026thinsp;\u0026plusmn;\u0026thinsp;4.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003eb*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.51\u0026thinsp;\u0026plusmn;\u0026thinsp;0.82\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e20.40\u0026thinsp;\u0026plusmn;\u0026thinsp;3.40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e\u003cp\u003e24.93\u0026thinsp;\u0026plusmn;\u0026thinsp;4.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSex\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.38\u0026thinsp;\u0026plusmn;\u0026thinsp;0.89\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003eb*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e20.14\u0026thinsp;\u0026plusmn;\u0026thinsp;3.25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003eb*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e\u003cp\u003e24.09\u0026thinsp;\u0026plusmn;\u0026thinsp;4.20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.008\u003csup\u003eb*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.29\u0026thinsp;\u0026plusmn;\u0026thinsp;0.90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e19.82\u0026thinsp;\u0026plusmn;\u0026thinsp;3.21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e\u003cp\u003e23.87\u0026thinsp;\u0026plusmn;\u0026thinsp;4.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e60\u0026ndash;69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.55\u0026thinsp;\u0026plusmn;\u0026thinsp;0.88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003ea*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e20.60\u0026thinsp;\u0026plusmn;\u0026thinsp;3.34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003ec*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e\u003cp\u003e24.60\u0026thinsp;\u0026plusmn;\u0026thinsp;4.37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003ec*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e70\u0026ndash;79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.35\u0026thinsp;\u0026plusmn;\u0026thinsp;0.87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e20.05\u0026thinsp;\u0026plusmn;\u0026thinsp;3.21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e\u003cp\u003e23.92\u0026thinsp;\u0026plusmn;\u0026thinsp;4.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e80 and Above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.09\u0026thinsp;\u0026plusmn;\u0026thinsp;0.93\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e19.25\u0026thinsp;\u0026plusmn;\u0026thinsp;3.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e\u003cp\u003e23.57\u0026thinsp;\u0026plusmn;\u0026thinsp;3.81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarital Status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.39\u0026thinsp;\u0026plusmn;\u0026thinsp;0.88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003eb*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e20.18\u0026thinsp;\u0026plusmn;\u0026thinsp;3.23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003eb*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e\u003cp\u003e24.07\u0026thinsp;\u0026plusmn;\u0026thinsp;4.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003eb*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSingle\u003csup\u003e#\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.18\u0026thinsp;\u0026plusmn;\u0026thinsp;0.93\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e19.40\u0026thinsp;\u0026plusmn;\u0026thinsp;3.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e\u003cp\u003e23.71\u0026thinsp;\u0026plusmn;\u0026thinsp;4.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEducation Level\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIlliterate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.21\u0026thinsp;\u0026plusmn;\u0026thinsp;0.93\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003ec*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e19.40\u0026thinsp;\u0026plusmn;\u0026thinsp;3.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003ec*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e\u003cp\u003e23.57\u0026thinsp;\u0026plusmn;\u0026thinsp;3.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003ec*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePrimary School\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.19\u0026thinsp;\u0026plusmn;\u0026thinsp;0.82\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e19.27\u0026thinsp;\u0026plusmn;\u0026thinsp;3.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e\u003cp\u003e24.52\u0026thinsp;\u0026plusmn;\u0026thinsp;3.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMiddle School\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.32\u0026thinsp;\u0026plusmn;\u0026thinsp;0.89\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e19.97\u0026thinsp;\u0026plusmn;\u0026thinsp;3.22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e\u003cp\u003e23.62\u0026thinsp;\u0026plusmn;\u0026thinsp;4.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHigh School and Above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.45\u0026thinsp;\u0026plusmn;\u0026thinsp;0.88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e20.53\u0026thinsp;\u0026plusmn;\u0026thinsp;3.27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e\u003cp\u003e24.62\u0026thinsp;\u0026plusmn;\u0026thinsp;4.46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eResidence\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUrban\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.34\u0026thinsp;\u0026plusmn;\u0026thinsp;0.89\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.384\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e20.31\u0026thinsp;\u0026plusmn;\u0026thinsp;3.25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003eb*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e\u003cp\u003e24.11\u0026thinsp;\u0026plusmn;\u0026thinsp;4.22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.001\u003csup\u003eb*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRural\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.32\u0026thinsp;\u0026plusmn;\u0026thinsp;0.91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e19.60\u0026thinsp;\u0026plusmn;\u0026thinsp;3.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e\u003cp\u003e23.83\u0026thinsp;\u0026plusmn;\u0026thinsp;3.96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBMI\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNormal Weight\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.16\u0026thinsp;\u0026plusmn;\u0026thinsp;0.98\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003ea*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e19.98\u0026thinsp;\u0026plusmn;\u0026thinsp;3.23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003ea*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e\u003cp\u003e24.03\u0026thinsp;\u0026plusmn;\u0026thinsp;4.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003ec*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUnderweight\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.35\u0026thinsp;\u0026plusmn;\u0026thinsp;0.89\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e19.18\u0026thinsp;\u0026plusmn;\u0026thinsp;3.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e\u003cp\u003e23.58\u0026thinsp;\u0026plusmn;\u0026thinsp;3.43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOverweight\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.35\u0026thinsp;\u0026plusmn;\u0026thinsp;0.90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e20.15\u0026thinsp;\u0026plusmn;\u0026thinsp;3.25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e\u003cp\u003e24.11\u0026thinsp;\u0026plusmn;\u0026thinsp;4.31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eObesity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.11\u0026thinsp;\u0026plusmn;\u0026thinsp;0.87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e19.94\u0026thinsp;\u0026plusmn;\u0026thinsp;3.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e\u003cp\u003e22.44\u0026thinsp;\u0026plusmn;\u0026thinsp;4.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSocioeconomic Status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHigh\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.35\u0026thinsp;\u0026plusmn;\u0026thinsp;0.89\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003ec*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e20.21\u0026thinsp;\u0026plusmn;\u0026thinsp;3.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003ea*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e\u003cp\u003e24.17\u0026thinsp;\u0026plusmn;\u0026thinsp;4.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003ec*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMiddle\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.36\u0026thinsp;\u0026plusmn;\u0026thinsp;0.88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e19.98\u0026thinsp;\u0026plusmn;\u0026thinsp;3.24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e\u003cp\u003e24.00\u0026thinsp;\u0026plusmn;\u0026thinsp;3.93\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSmoking Status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLow\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.14\u0026thinsp;\u0026plusmn;\u0026thinsp;0.99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e19.62\u0026thinsp;\u0026plusmn;\u0026thinsp;3.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e\u003cp\u003e23.55\u0026thinsp;\u0026plusmn;\u0026thinsp;4.47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.37\u0026thinsp;\u0026plusmn;\u0026thinsp;0.90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.006\u003csup\u003eb*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e20.26\u0026thinsp;\u0026plusmn;\u0026thinsp;3.22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003eb*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e\u003cp\u003e23.88\u0026thinsp;\u0026plusmn;\u0026thinsp;4.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.131\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.32\u0026thinsp;\u0026plusmn;\u0026thinsp;0.90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e19.87\u0026thinsp;\u0026plusmn;\u0026thinsp;3.22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e\u003cp\u003e24.02\u0026thinsp;\u0026plusmn;\u0026thinsp;4.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003csup\u003e#\u003c/sup\u003e Including never married, divorced and widowed.\u003c/p\u003e\u003cp\u003e\u003csup\u003e*\u003c/sup\u003e \u003cem\u003eP\u003c/em\u003e is statistically significant (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e\u003cp\u003e\u003csup\u003ea\u003c/sup\u003e\u003cem\u003eP\u003c/em\u003e values were derived from one-way ANOVA.\u003c/p\u003e\u003cp\u003e\u003csup\u003eb\u003c/sup\u003e\u003cem\u003eP\u003c/em\u003e values were derived from independent-samples \u003cem\u003et\u003c/em\u003e-test.\u003c/p\u003e\u003cp\u003e\u003csup\u003ec\u003c/sup\u003e\u003cem\u003eP\u003c/em\u003e values were derived from Kruskal-Wallis test.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eCorrelation Between Adverse Childhood Experience and Health Status of Older Adults\u003c/h3\u003e\n\u003cp\u003eThis study used multiple linear regression to explore the correlation between the health status of the elderly population and their adverse childhood experiences. Our regression model showed that after including control variables, childhood experiences of parental death (for physical health: \u003cem\u003eβ\u003c/em\u003e = -0.067, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001; for psychological health: \u003cem\u003eβ\u003c/em\u003e = -0.065, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and starvation (for physical health: \u003cem\u003eβ\u003c/em\u003e = -0.108, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001; for psychological health: \u003cem\u003eβ\u003c/em\u003e = -0.057, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001; for social health: \u003cem\u003eβ\u003c/em\u003e = -0.132, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) were significantly associated with poorer health status in old age. Conversely, limited access to medical resources in childhood was positively correlated with health status in later life (for physical health: \u003cem\u003eβ\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.043, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001; for psychological health: \u003cem\u003eβ\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.075, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001; for social health: \u003cem\u003eβ\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.074, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eMultiple Linear Regression Analysis of Adverse Childhood Experience and Health Status of the Elderly Population\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"9\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003ePhysical Health\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003ePsychological Health\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e\u003cp\u003eSocial Health\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cem\u003eβ\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003eβ\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cem\u003eβ\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eParental Death in Childhood (\u0026ldquo;No\u0026rdquo; as reference)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-0.067\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e-0.065\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.002\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.965\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eInadequate Access to Medical Resources in Childhood (\u0026ldquo;No\u0026rdquo; as reference)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.043\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.075\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.074\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eChildhood Experience of Starvation (\u0026ldquo;No\u0026rdquo; as reference)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-0.108\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e-0.057\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e-0.132\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSex (\u0026ldquo;Male\u0026rdquo;as reference)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-0.026\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e-0.017\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.147\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e-0.026\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.024\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e60\u0026ndash;69(Reference)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e70\u0026ndash;79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-0.090\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e-0.060\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e-0.060\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e80 and Above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-0.166\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e-0.118\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e-0.064\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarital Status (\u0026ldquo;Married\u0026rdquo;as reference)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-0.039\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e-0.051\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e-0.008\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.438\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEducation Level\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIlliterate(Reference)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePrimary School\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.010\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.341\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e-0.017\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.121\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.039\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMiddle School\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.024\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.064\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.039\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.002\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e-0.012\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.337\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHigh School and Above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.061\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.068\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.077\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eResidence (\u0026ldquo;Urban\u0026rdquo; as reference)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.019\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.084\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e-0.076\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e-0.002\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.851\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBMI\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNormal Weight(Reference)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUnderweight\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-0.034\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e-0.037\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e-0.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.270\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOverweight\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-0.012\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.233\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.003\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.320\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.965\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eObesity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-0.039\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e-0.002\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.854\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e-0.062\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSocioeconomic Status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMiddle(Reference)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHigh\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-0.025\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.017\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.010\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.331\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.004\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.721\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLow\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-0.076\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e-0.040\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e-0.033\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSmoking Status (\u0026ldquo;No\u0026rdquo; as reference)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-0.018\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.108\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e-0.038\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.023\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.042\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003csup\u003e*\u003c/sup\u003e \u003cem\u003eP\u003c/em\u003e is statistically significant (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe average scores for physiological health, psychological health, and social health among Chinese elderly individuals are consistent with those previously reported by Si et al[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]., Li et al[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]., and Li et al[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].Multiple linear regression analysis revealed that experiencing parental death during childhood negatively impacted both the physiological and psychological health later in life. For physiological health, the role that parents serve as the cornerstone of family stability and the safety and care they provide are irreplaceable for a child\u0026rsquo;s development. The presence of parents in a home alleviates financial burdens and ensures that children receive adequate nutrition and hygiene, thereby facilitating healthy growth. Additionally, prior work has shown that parental death during childhood could impact telomere length, which in turn influence cognitive function and accelerate biological aging[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. For psychological health, the passing of one or both parents disrupts family structure and fosters feelings of inferiority and a lack of self-confidence during adolescence[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Rather than an isolated event, the loss of a loved one imposes a persistent emotional burden, and the long-term psychological impact manifests in symptoms such as depression, anxiety, and a long-lasting sense of loneliness and helplessness.\u003c/p\u003e\u003cp\u003eOur analysis showed that elderly individuals who experienced childhood starvation had worse physiological and psychological health compared to those who did not. Previous studies have suggested that experiences of food insecurity primarily might affect elderly health through diminished household income, disadvantages in education, and nutrition deficiency[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Lower life expectancy, higher levels of depression and poorer overall mental health have also been observed[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Interestingly, the surveyed population in this study lived through a period marked by severe natural disasters and widespread famine, particularly in major grain-producing regions, leading to significant food shortages. The physical and emotional toll of enduring prolonged hunger left an indelible mark on their psychological and social well-being. We also found that childhood starvation had negative effect on social health in old age. Previous studies indicated the elderly with lower childhood socioeconomic status (SES) exhibited significantly lower rates of social engagement compared to those with higher childhood SES. According to the life course theory and international consensus, childhood starvation experience serves as one of the key indicators for assessing SES. Therefore, childhood starvation may adversely affect social health in later life. A study abroad has found that social participation among the elderly is related to their socioeconomic status during childhood. The social participation rate of elderly individuals with a lower socioeconomic status during childhood is significantly lower than that of middle-aged and elderly individuals with a higher socioeconomic status[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. According to the life course theory and the internationally accepted measurement methods for socioeconomic status, experiencing hunger during childhood is one of the indicators for measuring socioeconomic status[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Therefore, experiencing hunger during childhood will affect social health to some extent.\u003c/p\u003e\u003cp\u003eIt is worth noting that a positive correlation exists between experiencing limited medical resources during childhood and better physiological, psychological, and social health in old age. In other words, elderly individuals who lacked access to medical resources in childhood reported better physical health, lower depression levels, and greater psychological resilience. Since this study measures physiological health through self-rated health assessments, this suggests that older adults perceive their childhood experiences of medical scarcity as a factor that strengthened their physical resilience. Survey data showed that more than 70% of the elderly respondents considered the medical resources they received to be insufficient. This reflects the fact that this age group of individuals grew up with underdeveloped medical care, poor sanitation, and inadequate healthcare infrastructure. With inequitably distributed medical resources, lack of comprehensive health insurance coverage, and insufficient training and technical expertise among medical professionals, many resorted to traditional remedies or relied on self-healing for minor illnesses[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Physiologically, the process of self-recovery may have strengthened their immune system[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e] Psychologically, surviving numerous illnesses without medical intervention reinforced the belief in their physical resilience, fostering a more positive and proactive attitude toward life[\u003cspan additionalcitationids=\"CR23\" citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Socially, elderly individuals with limited childhood medical resources often relied on community-based support system, which in turn boosted their social interactions and contributed to better social health[\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eOur results also indicated that being female, middle-aged or older, single, living in rural areas, having a BMI classified as underweight or obese, having poor or excellent economic conditions, and smoking were all associated with poorer health outcomes. In contrast, a higher level of education was linked to better health. These findings highlight the significant influence of personal experiences, socioeconomic status, lifestyle, and environmental factors on health outcomes[\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Existing literature has shown that perceived poverty may have a strong negative impact on the psychological health of the elderly, consistent with our findings[\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Specifically, elderly individuals with poorer economic conditions experienced more severe mental health challenges. Additionally, education level served as a mediating variable in self-rated health among middle-aged and elderly individuals[\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Study by Wang et al. further suggested that a higher education level facilitates social engagement and adaptation in old age[\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. These findings underscore the positive influence of education on physiological and social health, mitigating the adverse effects of adverse childhood experiences on later-life health. Overall, the negative impact of adverse childhood experiences on health is profound, enduring, and difficult to erase[\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eWhile existing literature on elderly health predominantly investigated the relationship between current behaviors and health status, this study explored the link between health and childhood experience by retrospectively examining events such as starvation, parental loss, and inadequate medical resources. By primarily focusing on the childhood stage, the large sample size of 9.170 enrollments provides robust insights into how these experiences influence an individual\u0026rsquo;s health in later life stages, thereby contributing to the cumulative knowledge on the interplay between early-life adversities and life quality in the elderly.\u003c/p\u003e\u003cp\u003eThis study is also bound by several limitations. First, the survey used self-reported data to assess physical health. While self-reporting has been a standard method in literature, the respondent\u0026rsquo;s subjective feelings of well-being might divert from an objective medical assessment[\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. Secondly, selection bias could contribute to the underestimate of adverse childhood experiences\u0026rsquo; impact on health outcome, as many individuals with such experiences might have passed away, leaving a survival population that was potentially healthier and more resilient[\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. Multi-wave longitudinal data and the application of inverse probability weighting methods to control for mortality selection could mitigate the effects of this selection bias[\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e].\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eIn conclusion, we found childhood parental death and starvation were associated with poorer health outcomes, whereas limited childhood medical resources were associate with better overall health. Therefore, while past negative experiences cannot be altered, targeted interventions can help mitigate their impact. Future efforts should focus on promoting physiological health through preventive measures, fostering psychological well-being by creating supportive environments, and enhancing social health through increased community participation and support systems. Additionally, it is crucial to foster resilience in children help them learn coping skills, develop an optimistic outlook when navigating adversity, managing stress, and overcoming challenges. Ultimately, health outcomes are shaped across the entire life course, with childhood experiences as pivotal moments that continue to shape a person\u0026rsquo;s adulthood and old age. Investment into child protection measures will have a long-lasting impact on public health.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe thank the support from Fujian Research Association for Medical and Health System Reform.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eJW and YZ designed the study. MS managed and analyzed the data. JW and MS prepared the first draft. JW, YZ, and MS reviewed and edited the manuscript, with comments from JW, YZ, MS, and MC. All authors were involved in revising the paper, and MS had full access to the data and gave final approval of the submitted versions.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was supported by National Social Science Foundation of China（23BSH096）; 2021 Basic Theoretical Research Project of Philosophy and Social Sciences Disciplines Guided by Marxism in Universities (JSZM2021026) and Research Project of Fujian Association for Science and Technology Innovation Think Tank in 2024 (FJKY-2024XKB010).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data source of this study was a publicly available database, China Longitudinal Aging Social Survey, which was hosted by the China Survey and Data Center, Renmin University of China. The data are available at http://class.ruc.edu.cn/.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors give consent for publication of this paper in BMC Public Health.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor details\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e1\u003c/sup\u003eCapital Medical University, Beijing Friendship Hospital, Beijing, China\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e2\u003c/sup\u003eUMass Chan Medical School, Worcester, MA\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e3\u003c/sup\u003eSchool of Health Management, Fujian Medical University, Fuzhou, Fujian, China 350122\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e4\u003c/sup\u003eHealth and Elderly Care Professional Committee of Fujian Research Association for Medical and Health System, Fuzhou, Fujian, China 350122\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e5\u003c/sup\u003eFujian Research Association for Medical and Health System Reform,\u0026nbsp;Fuzhou, Fujian, China 350122\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e#\u003c/sup\u003eContributed equally.\u003c/p\u003e\n\u003cp\u003e*Corresponding Author:\u003c/p\u003e\n\u003cp\u003eMingshu Si, PhD, School of Health Management, Fujian Medical University, No.1 Xuefu North Road, Minhou University District, Fuzhou, Fujian, China 350122\u003c/p\u003e\n\u003cp\u003eE-mail：[email protected]; ORCID iD: 0009-0003-0929-261X\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eNational Bureau of Statistics. 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J Affect Disord. 2024;355. https://doi.org/10.1016/j.jad.2024.03.110.\u003c/li\u003e\n\u003cli\u003eBoccaccio DE, Cenzer I, Covinsky KE. Life satisfaction among older adults with impairment in activities of daily living. Age Ageing. 2021;50. https://doi.org/10.1093/ageing/afab172.\u003c/li\u003e\n\u003cli\u003eLin L, Cao B, Chen W, Li J, Zhang Y, Guo VY. Association of Adverse Childhood Experiences and Social Isolation with Later-Life Cognitive Function among Adults in China. JAMA Netw Open. 2022;5. https://doi.org/10.1001/jamanetworkopen.2022.41714.\u003c/li\u003e\n\u003cli\u003eMao Ping, Wang Lulu, Tan Minghui et al. Mental health status of adolescents with adverse childhood experience and the influencing factors. Cent South Univ (Med Sci). 2021; 46:1298\u0026ndash;305.\u003c/li\u003e\n\u003cli\u003eLi Y, Chen T, Li Q, Jiang L. The Impact of Subjective Poverty on the Mental Health of the Elderly in China: The Mediating Role of Social Capital. Int J Environ Res Public Health. 2023;20. https://doi.org/10.3390/ijerph20176672.\u003c/li\u003e\n\u003cli\u003eWang Qiong, Li Linchao, Liu Chen et al. Intermediary path analysis of the impact of childhood health on middle － aged and elderly health from the perspective of life course. Modern Preventive Medicine. 2022; 49:2795\u0026ndash;801.\u003c/li\u003e\n\u003cli\u003eWang Lihua, Gao Liang. The current social health status and influencing factors of elderly people in urban communities. Chinese Journal of Gerontology. 2018; 38:197\u0026ndash;8.\u003c/li\u003e\n\u003cli\u003eGuo Junqian, Hao Juan. The Influence of Unfavorable Chiwheod Experiences on Health Status of the Elderly. Scientific Research on Aging. 2020; 8:29\u0026ndash;40.\u003c/li\u003e\n\u003cli\u003eDu Xinyuan, Fang Ya, Zeng Yanbing. Study on Influence of Socioeconomic Position on Health Status of the Elderly in China from the Perspective of Life Course. Med Soc (Berkeley). 2023; 36:19-24,43.\u003c/li\u003e\n\u003cli\u003eHayward MD, Gorman BK. The long arm of childhood: The influence of early-life social conditions of men\u0026rsquo;s mortality. Demography. 2004;41. https://doi.org/10.1353/dem.2004.0005.\u003c/li\u003e\n\u003cli\u003eLiu Ruiping, Li Jianxin. The impact of adverse childhood experiences on the health of middle-aged and elderly people: a study based on selective treatment of death. Journal of Yunnan Minzu University (Philosophy and Social Sciences Edition). 2022; 39:66\u0026ndash;75.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Adverse childhood experiences, Elderly, geriatric health, CLASS database, Social determinants of health","lastPublishedDoi":"10.21203/rs.3.rs-7336528/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7336528/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cem\u003eBackground: \u003c/em\u003eThe impact of adverse childhood experiences (ACEs) on physical, psychological and social health in elderly life remains to be explored.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eMethods: \u003c/em\u003eThis study utilized data from the 2020 Chinese Longitudinal Aging Social Survey (CLASS). Descriptive statistics, \u003cem\u003et\u003c/em\u003e-tests, one-way ANOVA, and multiple linear regression analyses were conducted to assess the impact of adverse childhood experiences on physical, psychological, and social health in later life.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eResults: \u003c/em\u003eLinear regression showed that childhood experiences of parental death (for physical health: \u003cem\u003eβ\u003c/em\u003e = -0.067, \u003cem\u003eP \u003c/em\u003e\u0026lt; 0.001; for psychological health: \u003cem\u003eβ\u003c/em\u003e= -0.065,\u003cem\u003e P\u003c/em\u003e \u0026lt; 0.001) and starvation (for physical health: \u003cem\u003eβ\u003c/em\u003e = -0.108,\u003cem\u003e P \u003c/em\u003e\u0026lt; 0.001; for psychological health: \u003cem\u003eβ\u003c/em\u003e = -0.057, \u003cem\u003eP\u003c/em\u003e\u0026lt; 0.001; for social health:\u003cem\u003e β\u003c/em\u003e = -0.132, \u003cem\u003eP\u003c/em\u003e \u0026lt; 0.001) were significantly associated with poorer health status in old age. Conversely, limited access to medical resources in childhood was positively correlated with health status in later life (for physical health: \u003cem\u003eβ\u003c/em\u003e = 0.043, \u003cem\u003eP\u003c/em\u003e\u0026lt; 0.001; for psychological health: \u003cem\u003eβ\u003c/em\u003e = 0.075, \u003cem\u003eP\u003c/em\u003e \u0026lt; 0.001; for social health: \u003cem\u003eβ\u003c/em\u003e = 0.074, \u003cem\u003eP\u003c/em\u003e \u0026lt; 0.001).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eConclusions: \u003c/em\u003eACEs including parental death, starvation, and limited healthcare access, have lasting effects on physical, psychological, and social well-being in older adults. Integrating medical and social support systems should be considered by policymakers to mitigate the long-term health impacts of ACEs.\u003c/p\u003e","manuscriptTitle":"A Correlation Study Between Adverse Childhood Experiences and Health Status of Elderly People in China ","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-02 09:09:51","doi":"10.21203/rs.3.rs-7336528/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2025-09-18T09:08:43+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"171289160676973781160064100830744607978","date":"2025-09-18T08:59:57+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-08-25T08:13:21+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-08-18T14:19:10+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-08-14T04:55:39+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-08-14T04:55:09+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2025-08-10T03:08:15+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"a6e2f756-240b-4275-932d-6e48664b143f","owner":[],"postedDate":"September 2nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-09-02T09:09:52+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-02 09:09:51","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7336528","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7336528","identity":"rs-7336528","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}