25 The association of exposure to adverse childhood experiences and receipt of social security disability benefits

Abstract

In this study, we investigate the association between exposure to adverse childhood experiences and long-term disability using receipt of Social Security Disability Insurance (SSDI) benefits as a proxy for disability as a measure of economic impact. Survey data were obtained over an eight-month period (ending in March 2014) from a convenience sample of patients attending two private psychology practices, and parishioners attending a local church in western Nebraska. Data were collected using the Adverse Childhood Experiences (ACE) Study questionnaire, which collects information on eight areas of exposure (e.g., abuse and household dysfunction). Respondents were also asked for the status of SSDI applications and several demographic questions. The Student’s t-test and the two-sample test of proportions were used to test for statistically significant differences in total ACE score and individual ACE Study questions, respectively, by receipt of SSDI. The response rate was 64% (n = 96 out of 150) and respondents were mostly female (75%) with an average age of 48.2 years (range: 19–92). The mean total ACE score was significantly larger, indicating more adverse exposures, for respondents who received SSDI benefits (p = 0.037) compared to those who did not receive benefits. Exposure to sexual abuse (p = 0.014), neglect (p = 0.046), and a household member with mental illness (p = 0.012) were significantly associated with receipt of SSDI. Respondents who received SSDI were significantly more likely to report more exposure to adverse childhood experiences, particularly child maltreatment. These results suggest that the economic impact of child maltreatment may be underestimated if the long-term effect on the ability to work is not included. No previous studies have been conducted to determine the association of adverse childhood experiences and costly SSDI benefits. Investigating this association will provide policy makers with an understanding of the true economic burden of these events and, ultimately, lead to more resources to prevent these exposures.