Examining Economic Risks in Adolescents’ Families, Schools, and Neighborhoods: Implications for Mental and Behavioral Health

• In Event: 3-016 - Differential Effects of Socioeconomic Contexts Over Time and Over Individuals on Health and Educational Attainment

Integrative Statement

Introduction: Research has extensively highlighted the risks that family poverty poses for mental and behavioral health problems among youth. Recent work has expanded this line of research by shifting away from the disproportionate focus on poverty in order to also consider threats associated with affluence, as well as by assessing the relative importance of economic risks derived from family, school, and neighborhood contexts. The current study further extends and builds upon this work by considering long-term links between economic contexts in adolescence and mental and behavioral health in young adulthood.

Study Population: Data were drawn from Waves 1 and 4 (W1 and W4) of the National Longitudinal Study of Adolescent Health. The sample included all participants attending high schools at W1 with valid weights at W4 (N=10,710). At W4, young adults self-reported on their depressive symptoms (9 items from the CES-D), perceived psychological stress (4 items from Cohen’s Perceived Stress Scale), and alcohol use disorder (11 items from DSM-5; coded to indicate no, mild, moderate, or severe disorder). At W1, family income was derived from parent report. Neighborhood income was assessed from Census data on average household income. School income was derived from aggregated family income. Individual income at W4 was derived from self-report; Census data on average household income assessed W4 neighborhood income.

Method: Multilevel models assessed associations between income in adolescence and adult outcomes (W4, average age 29) while accounting for income in young adulthood. Links with depressive symptoms and stress were assessed utilizing lagged OLS regression; alcohol use disorder was assessed using lagged ordered logistic regression, with all models controlling for parallel prior measures, self-reported in adolescence, as lags to help adjust for unmeasured, time-invariant forced affecting health. Nonlinearities in income effects were assessed with quadratic income variables.

Results: Table 1 presents results for models assessing links between income in adolescence and young adult outcomes, accounting for income in young adulthood. Family income emerged as the most consistent predictor of depressive symptoms and stress, showing negative curvilinear associations (with effect sizes of -.08 and -.09, respectively). School income showed a curvilinear association with stress, with the highest levels seen among young adults from middle-income families (Figure 1). In contrast, attending and living in schools and neighborhoods with more affluent peers was associated with heightened risks for alcohol use disorder. Each $10,000 unit shift in school income was associated with a 1.067 greater odds of being in a higher category of alcohol use disorder, while each unit shift in neighborhood income was associated with a 1.105 greater odds. In addition, family and neighborhood economic contexts in young adulthood emerged as negatively associated with depressive symptoms (effect sizes of -.17 and -.08, respectively) and stress (effect sizes of -.08 and -.05). Findings call attention to persistent risks across the socioeconomic spectrum—not only at the lower end—and also highlight the importance of broader economic contexts beyond the family context.

Authors

• Jacqueline Prince Sims, Boston University
  Presenting Author

• Rebekah Levine Coley, Boston College
  Non-Presenting Author