Research by Jin Yu and colleagues published in The Lancet: Regional Health Americas shows that clusters of adverse childhood experiences do somewhat better at accounting for the risk of death in mid-adulthood than do cumulative ACE scores. In particular, clusters including poverty and parental separation and poverty and crowded housing increase the risk of premature death by about 50%.

The authors conclude that, “the totality of evidence demands expanded efforts to prevent and reduce children’s exposure to toxic stressors particularly poverty, poor housing conditions, and parental
separation. Once adversities occur, findings such as ours highlight the importance of integrating anti-poverty programs with family-based interventions in mitigating the long-term consequences of early adversity.”

See “Adverse childhood experiences and premature mortality through mid-adulthood: A five-decade prospective study” https://www.thelancet.com/pdfs...-193X(22)00166-1.pdf