Background: The objective of the study was to determine the association between adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) with family health in adulthood. Prior research indicates that ACEs and PCEs affect individual physical and mental health in adulthood. However, little is known about how ACEs and PCEs affect family health. Families develop and function through patterns and routines which are often intergenerational. Therefore, a person’s early experiences may influence their family’s health in adulthood. Method: A survey was administered to 1030 adults through Qualtrics, with participants recruited using quota-sampling to reflect the demographic characteristics of U.S. adults. Participants completed a survey about their childhood experiences, four domains of family health (family social and emotional health processes, family healthy lifestyle, family health resources, and family external social supports), and demographic characteristics. Data were analyzed using structural equation modeling. Results: After controlling for marriage, education, gender, race and age, ACEs were negatively associated with family social and emotional health processes and family health resources when accounting for PCEs; PCEs were positively associated with all four family health domains irrespective of ACEs. Conclusion: Childhood experiences affect family health in adulthood in the expected direction. Even in the presence of early adversity, positive experiences in childhood can provide a foundation for creating better family health in adulthood.

Families strongly influence the health of communities and individuals across the life course, but no validated measure of family health exists. The absence of such a measure has limited the examination of family health trends and the intersection of family health with individual and community health. The purpose of this study was to examine the reliability and validity of the Family Health Scale (FHS), creating a multi-factor long-form and a uniform short-form. The primary sample included 1,050 adults recruited from a national quota sample Qualtrics panel. Mplus version 7 was used to analyze the data using a structural equation modeling framework. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) confirmed a 32-item, 4-factor long-form scale. The four factors included (1) family social and emotional health processes; (2) family healthy lifestyle; (3) family health resources; and (4) family external social supports. A 10-item short-form of the FHS was also validated in the initial sample and a second sample of 401 adults. Both the long-form and short-form FHS correlated in the expected direction with validated measures of family functioning and healthy lifestyle. A preliminary assessment of clinical cutoffs in the short-form were correlated with depression risk. The FHS offers the potential to assess family health trends and to develop accessible, de-identified databases on the well-being of families. Important next steps include validating the scale among multiple family members and collecting longitudinal data.