This paper describes four possible pathways by which childhood abuse relates to health problems in adults. Literature on the long-term effects of childhood abuse is organized in a health psychology framework describing behavioral, social, cognitive and emotional pathways. Key studies from the health psychology and behavioral medicine literature are included to demonstrate how these pathways relate to health. Childhood abuse puts people at risk of depression and PTSD, participating in harmful activities, having difficulties in relationships, and having negative beliefs and attitudes towards others. Each of these increases the likelihood of health problems, and they are highly related to each other. Childhood abuse is related to health via a complex matrix of behavioral, emotional, social and cognitive factors. Health outcomes for adult survivors are unlikely to improve until each of these factors is addressed.