Adverse childhood experiences impact unemployment and inability to work among adults in the United States

Introduction: In the context of employment, adults who had Adverse Childhood Experiences (ACE) may face unique barriers to employment due to physical, behavioral, and psychological effects. This study examines the relationship between ACEs and employment status, exploring how health behaviors and chronic illness may affect this association. Methods: This study draws on 2020-2024 Behavioral Risk Factor Surveillance System (BRFSS) data from 193,742 U. S. adults across 27 states, the District of Columbia, and 2 territories. Analyses involved bivariate analyses and regression techniques, adjusting for selected covariates. Results: Each of the 11 types of ACEs were significantly associated with lower odds of employment in adulthood, after adjusting for the demographic covariates. Even one ACE was sufficient to lower the odds of employment. As the number of ACEs increased, the odds of employment decreased. Children experiencing forced sexual contact had the lowest employment as adults. Among the specific covariates considered, education, household income, smoking, and chronic illness had the strongest effects on the association between the number of ACEs and employment. Discussion: These findings support existing evidence that ACEs contribute to long-term social and economic disadvantages. The study highlights the need for interventions that address the association between ACEs and unemployment.