Abuse during childhood and young adulthood is linked to welfare receipt

1. Experiencing either physical abuse alone or both physical and sexual abuse before the age of 18 is associated with a two-fold increased risk of welfare receipt in adulthood.

2. Experiencing both child abuse and intimate partner violence in young adulthood is associated with a three-fold increase in the risk of welfare receipt.

Evidence Rating Level: 2 (Good)

Study Rundown: Child abuse and intimate partner violence in young adulthood have been linked to worse long-term mental and physical health outcomes, but evidence for the financial impacts in adulthood remains scant. By linking reports of abuse (physical and sexual abuse before age 18, and intimate partner violence from ages 18-22) with tax record data, this study aimed to investigate the associations between various types and timing of abuse and welfare receipt. Overall, the authors found a two-fold increased risk of welfare receipt among individuals who experienced either physical abuse alone or both physical and sexual abuse before the age of 18. They similarly reported a three-fold increase in the risk of welfare receipt for individuals who experienced both child abuse and intimate partner violence between the ages of 18 and 22. With a sample size of 1690 participants, this is the largest study of the economic consequences of abuse to date. The analysis also benefits from rigorous epidemiologic methods, particularly the authors’ decision to control for family-level socioeconomic status during childhood. Limitations include a reliance on self-report for documentation of experiences of abuse. Additional evidence will be needed to assess the generalizability of these findings to a more diverse sample.

Click to read the study in Pediatrics

Click to read an accompanying editorial in Pediatrics

Relevant Reading: Longitudinal outcomes for victims of child abuse

In-Depth [prospective cohort]: Using data from the Quebec Longitudinal Study of Kindergarten Children, this study linked retrospective self-reports of abuse (physical and sexual abuse during childhood; intimate partner violence between the ages of 18 and 22) with tax records. Negative binomial regression was used to measure the association between years of welfare receipt (a count variable) and experience of abuse, with separate analyses run for type of abuse (physical, sexual, both, none) and timing of abuse (childhood, early adulthood, both). Models were adjusted for child characteristics (sex, IQ, disruptive behaviors during kindergarten) and family background (parental education, family structure, parental age at childbirth, maternal employment status at participant age 6, and parental income from participant ages 2 to 7). Multiple imputations were used to correct for missing data, and inverse probability weighting was used to account for attrition bias from the initial cohort. Results were reported as incidence rate ratios. Considering type of abuse first, individuals who experienced physical abuse alone and physical abuse in combination with sexual abuse were both at more than a two-fold risk of welfare receipt (IRR 2.43 and IR 2.04 respectively, p<0.001 for both). Sexual abuse was not associated with increased risk of welfare receipt after controlling for confounders. Next, considering timing of abuse, individuals who experienced both child abuse and intimate partner violence were at more than three-fold risk of welfare receipt (IR 3.59, p<0.001). Abuse during childhood or young adulthood alone were not associated with increased risk of welfare receipt after controlling for confounders.

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