Childhood Socioeconomic Circumstances and Health Risk Behavior in Adolescence: The Role of Exposure to Adversity

• In Event: 043 - Section on Alcohol, Drugs, and Tobacco Roundtable Session (one-hour).
  In Refereed Roundtable: Table 04. Social Factors and Substance Use

Abstract

Research provides conflicting evidence for the role of childhood socioeconomic status (SES) as an explanatory factor in the likelihood of adolescent substance use. Exposure to adverse childhood experience is one mechanism that may help explain complex patterns of associations between childhood SES and adolescent substance use. Data from the National Comorbidity Survey Replication Adolescent Supplement (NCS-A), a nationally representative face-to-face survey of adolescents aged 13 to 18 in the continental United States (n=10,059), is used to examine possible direct and indirect relationships among childhood SES, exposure to adverse experience in childhood, and adolescent substance use. Exposure to adverse childhood experience is hypothesized to mediate the relationship between childhood SES and adolescent substance use. Results showed that the associations between childhood SES and adolescent substance use varied by substance. Among childhood SES indicators, welfare receipt stood out as a circumstance that was associated with increased odds of use for every kind of substance examined here, and that these associations were consistently mediated by exposure to adverse childhood experience. Additionally, including childhood social and economic circumstances in the multivariate models showed that net of childhood SES and sociodemographic characteristics, the effect of reported exposure to adverse experiences greatly increased the odds of use for each substance. This association was pronounced for use of the kind of drugs common to mixed-use, dependence, and overdose, e.g. prescription and other drugs. Overall, these results confirm the importance of including indicators of early life context and experience as essential research on substance use among youth.

Author

• Teri Andrea Rosales, University of Michigan