Adverse Childhood Experiences, Depression and Mental Health Barriers to Work among Low-Income Women

Abstract

Recent research has connected childhood abuse to decreased physical and mental health for low-income women in Utah. Further, mental health has established a link to employment problems. This study conducted a secondary analysis of data collected from individuals accessing public assistance to investigate the relationships among retrospective self-reports of childhood emotional, physical and sexual abuse and prospective indicators of mental health and mental health barriers to work. Logistic regression models found strong relationships between childhood abuse and increased odds of depression and mental health barriers to work. Path models highlight the relative importance of depression for those reporting mental health as the biggest barrier to work. Recommendations for social workers, public health professionals, and program administrators are provided.

Mental Health and Wealth: Depression, Gender, Poverty, and Parenting

“…Traditionally, the focus of increasing women's employment has been on social factors that may impact employment (e.g., child care) and other structural barriers like transportation and flexible scheduling. Factors that impact an individual woman's ability to participate in the workforce, such as level of education and training, are considered by many policy makers, yet policies and many studies on women's economic advancement make little mention of psychological difficulties (Cambron et al 2015). Depression is an important barrier to economic advancement and to willingness to enter the labor force (Mossakowski 2009), and the existence, duration, and age of onset of depressive symptoms may prevent some pregnant and parenting women from leaving welfare for work in a timely manner (López-López et al 2020).…”

“…Possible pathways by which mental distress leads to reduced income include an inability to procure skills, training, and social benefits due to diminished energy and higher levels of discouragement (Krueger & Mueller 2011), poor physical health resulting from increased psychological distress (Scott et al 2016), and a change in family structure or environment (housing instability) due to depression and, subsequently, a reduction in household resources (Cambron et al 2015). In a study by Whooley et al (2002), people at risk of depression at baseline were almost twice as likely to have low income (<$25,000 in 1995-1996) 5 years later compared with those without risk of depression.…”

“…The importance of examining subgroups of women has been noted in additional studies of women with high levels of trauma symptoms. Exposure to early trauma and adversity was associated with long-term unemployment in a sample of low-income women, with the mechanisms that helped explain these associations being depressive symptoms (Cambron et al 2015). Research on the social stigma associated with receipt of welfare also has highlighted the interactions that occur and can be statistically assessed in the relationships between receipt of welfare, depressive symptoms, and employment.…”

“…Although a few studies from other countries are included, addressing global policies is beyond the scope of this article. Compared with other countries, the United States has distinct policies, including employment and economic policies (Cambron et al 2015). For example, even though parents and caregivers are working longer hours, America's child poverty rate is twice that of most wealthy countries (Hardy et al 2018).…”

Trauma-informed Temporary Assistance for Needy Families (TANF): A Randomized Controlled Trial with a Two-Generation Impact

“…The original ACEs studies were conducted at Kaiser Permanente in Southern California in two waves of data collection of over 17,000 members of their Health Maintenance Organization, where adverse childhood experiences reported by survey respondents were compared with current health status and behaviors (Anda et al 2006 ; Felitti et al 1998 ). Since then additional research studies have linked ACEs to work-limiting conditions such as depression, cardiovascular disease, autoimmune diseases, and food insecurity, while damaging work prospects and stable income (Adams et al 2013 ; Anda et al 2008 ; Breiding et al 2014 ; Cambron et al 2015 ; Chilton et al 2015 ; Danese et al 2009 ; Dube et al 2009 ; Staggs et al 2007 ). High exposure to adversity among TANF-eligible caregivers also has crippling effects for academic achievement, parenting, employment, and executive functioning capabilities (Evans et al 2011 ; Liu et al 2013 ; Lu et al 2008 ; Randles 2014 ).…”