# Adversities, Health and Resilience in Early Adulthood: An intergenerational, low-income country study

> **NIH NIH R01** · STATE UNIVERSITY NEW YORK STONY BROOK · 2024 · $641,899

## Abstract

Over the next 20 years, the number of young adults in Sub-Saharan Africa will increase to 174 million, rendering
the health, fertility behaviors and child investments of this cohort critical factors for the future development of the
continent. Many young adults in low-income countries (LICs) have experienced substantial childhood adversity,
a likely important impediment to future health. For example, the young adults that we propose to study in Malawi,
82% experienced physical abuse in childhood, 8% reported sexual abuse, 8% were orphaned, and 70% wit-
nessed domestic violence. What happens next—in young adulthood—will have ramifications for their own health
and that of their children. Our study leverages this young adult cohort to study the impacts of adverse childhood
experience (ACEs) on health both across life courses and across generations. We draw on the Malawi Longitu-
dinal Study of Families and Health (MLSFH), and specifically on the MLSFH-ACE cohort previously created to
study the longitudinal impacts of ACEs during adolescence. This cohort is now entering early adulthood, when
new health and parenting challenges emerge. This is a critical lifecycle stage to study pathways driving the
intergenerational transmission of adversities. We propose a new round of data collection on the MLSFH-ACE
cohort, their partners, and their children. In Aim 1, we will estimate the longitudinal impacts of ACEs on sexual,
reproductive, and mental health (SRMH) during emerging adulthood. Key outcomes include HIV incidence, early
pregnancy, and depression. In Aim 2, we will estimate the longitudinal impacts of ACEs on the timing and quality
of partnerships in emerging adulthood. ACEs may affect the timing and qualities of these partnerships, them-
selves a key determinant of emerging adult SRMH. For example, ACEs may influence when individuals marry
(e.g., child marriage), whom they select (e.g., age-disparate relationships), and the power dynamics that define
the relationship (e.g., partner violence). Thus, we will estimate the impact of ACEs on partnerships and the extent
to which this mediates SRMH outcomes. In Aim 3, we will estimate the longitudinal, intergenerational impacts of
ACEs on offspring of emerging adults. Our study will examine how the experiences and resulting wellbeing of
both mothers and fathers and their interaction influence young children (including their health, language and
social-emotional development. We will also document the intergenerational transmission of ACEs during early
life (eg, young children's exposure to domestic violence). In Aim 4, we will identify resilience processes that
reduce negative consequences of ACEs on emerging adults and their offspring. Despite experiencing ACEs,
many people thrive and create healthy families. Studying these processes in Malawi, an LIC where poverty is
endemic, will elucidate key sources of resilience that have evolved alongside such extreme adversities. Thus,
the study will provide unparal...

## Key facts

- **NIH application ID:** 10824863
- **Project number:** 1R01HD114246-01
- **Recipient organization:** STATE UNIVERSITY NEW YORK STONY BROOK
- **Principal Investigator:** Rachel Kidman
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $641,899
- **Award type:** 1
- **Project period:** 2024-09-18 → 2029-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10824863

## Citation

> US National Institutes of Health, RePORTER application 10824863, Adversities, Health and Resilience in Early Adulthood: An intergenerational, low-income country study (1R01HD114246-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10824863. Licensed CC0.

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