This study investigates the relationship between adverse childhood experiences (ACEs) and premature mortality in adulthood. The researchers collected baseline survey data from 17,337 adults aged 18 and older between 1995 and 1997, including information on health behaviors, health status, and exposure to ACEs such as abuse, witnessing domestic violence, and growing up in a household with mental illness or substance abuse. Follow-up assessments were conducted until December 31, 2006, to identify deaths. The study found that adults with six or more ACEs had an average life expectancy 20 years lower than those with no ACEs, with a nearly threefold increase in average years of potential life lost (YPLL). Multivariable-adjusted Cox proportional hazards regression showed that adults with six or more ACEs were 1.7 times more likely to die by age 75 and 2.4 times more likely to die by age 65 compared to those with no ACEs. The findings suggest that ACEs are associated with an increased risk of premature death, although the graded increase in risk across ACE categories was not observed. The study concludes that ACEs may contribute to premature death through mechanisms beyond documented health and social problems.This study investigates the relationship between adverse childhood experiences (ACEs) and premature mortality in adulthood. The researchers collected baseline survey data from 17,337 adults aged 18 and older between 1995 and 1997, including information on health behaviors, health status, and exposure to ACEs such as abuse, witnessing domestic violence, and growing up in a household with mental illness or substance abuse. Follow-up assessments were conducted until December 31, 2006, to identify deaths. The study found that adults with six or more ACEs had an average life expectancy 20 years lower than those with no ACEs, with a nearly threefold increase in average years of potential life lost (YPLL). Multivariable-adjusted Cox proportional hazards regression showed that adults with six or more ACEs were 1.7 times more likely to die by age 75 and 2.4 times more likely to die by age 65 compared to those with no ACEs. The findings suggest that ACEs are associated with an increased risk of premature death, although the graded increase in risk across ACE categories was not observed. The study concludes that ACEs may contribute to premature death through mechanisms beyond documented health and social problems.