title: Relationship between adverse childhood experiences and unemployment among adults from five U.S. states.
abstract: OBJECTIVE
  Our study assesses the relationships between self-reported adverse childhood experiences (ACEs) (including sexual, physical, or verbal abuse, along with household dysfunction including parental separation or divorce, domestic violence, mental illness, substance abuse, or incarcerated household member) and unemployment status in five US states in 2009.
  
  
  METHODS
  We examined these relationships using the 2009 Behavioral Risk Factor surveillance system survey data from 17,469 respondents (aged 18-64 years) who resided in five states, completed the ACE Questionnaire, and provided socio-demographic and social support information. We also assessed the mediation of these relationships by respondents' educational attainment, marital status, and social support.
  
  
  RESULTS
  About two-third of respondents reported having had at least one ACEs, while 15.1% of men and 19.3% of women reported having had ≥4 ACEs. Among both men and women, the unemployment rate in 2009 was significantly higher among those who reported having had any ACE than among those who reported no ACEs (p < 0.05). Educational attainment, marital status, and social support mediated the relationship between ACEs and unemployment, particularly among women.
  
  
  CONCLUSIONS
  ACEs appear to be associated with increased risk for unemployment among men and women. Further studies may be needed to better understand how education, marital status, and social support mediate the association between multiple ACEs and unemployment.
authors.affiliation: Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), 4770 Buford Highway, NE, Mail-Stop K-67, Atlanta, GA 30341, USA. ikd8@cdc.gov
authors.forename: Yong
authors.initials: Y
authors.lastname: Liu
authors.forename: Janet B
authors.initials: JB
authors.lastname: Croft
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Chapman
authors.forename: Geraldine S
authors.initials: GS
authors.lastname: Perry
authors.forename: Kurt J
authors.initials: KJ
authors.lastname: Greenlund
authors.forename: Guixiang
authors.initials: G
authors.lastname: Zhao
authors.forename: Valerie J
authors.initials: VJ
authors.lastname: Edwards
mesh_terms: D000293:Adolescent; D000328:Adult; D040343:Behavioral Risk Factor Surveillance System; D002649:Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data; D017579:Domestic Violence; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012944:Social Support; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders; D011795:Surveys and Questionnaires; D014478:Unemployment / Q000523:psychology* / Q000706:statistics & numerical data; D014481:United States; D055815:Young Adult