title: Longitudinal perspective: adverse childhood events, substance use, and labor force participation among homeless adults.
abstract: OBJECTIVE
  We examined the long-term effects of adverse childhood events on adulthood substance use, social service utilization, and subsequent labor force participation.
  
  
  METHODS
  A county-wide probability sample of 397 homeless adults was interviewed three times in a 15-month period. By using a path model, literature-based relationships between adverse childhood events and labor force participation with the mediating effects of adulthood substance use and service use were tested.
  
  
  RESULTS
  Adverse childhood events were precursors to adulthood alcohol and drug use. Consistent substance use was negatively associated with long-term labor force participation and with social service utilization among homeless adults. Adverse events at childhood, however, were positively associated with service use.
  
  
  CONCLUSIONS
  Adverse childhood events may contribute to negative adulthood consequences, including consistent substance use and reduced labor force participation. Agencies that are involved in halting the abuse or neglect also should participate in more preventive interventions. Job-related assistance is particularly important to facilitate employment and labor force participation among homeless adults.
authors.affiliation: Alcohol Research Group, Public Health Institute, Berkeley, California 94709, USA. ttam@arg.org
authors.forename: Tammy W
authors.initials: TW
authors.lastname: Tam
authors.forename: Cheryl
authors.initials: C
authors.lastname: Zlotnick
authors.forename: Marjorie J
authors.initials: MJ
authors.lastname: Robertson
mesh_terms: D000328:Adult; D002140:California / Q000453:epidemiology; D002648:Child; D002649:Child Abuse / Q000523:psychology*; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D005581:Foster Home Care; D006703:Ill-Housed Persons / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D012044:Regression Analysis; D012947:Social Work; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D013995:Time