Childhood Sexual Abuse and Adult Work Outcomes

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The authors explored the relationship among childhood sexual abuse (CSA), physical and mental health work barriers, and employment outcomes using a large panel study of current and former welfare recipients. Controlling for human capital and demographic characteristics, they found CSA was associated with significantly fewer months worked over the 33-month period immediately following the 1996 welfare reform legislation. CSA was also strongly associated with presence of a mental or physical health work barrier during that same time period, and those variables mediated the relationship between CSA and employment. The data suggest that human capital variables alone do not account for women's work outcomes and that intervention is needed in the welfare system to address women's work barriers, including the long-term consequences of CSA. KEY WORDS: child sexual abuse; employment; mental health; welfare; work barriers ********** Employment is increasingly a reality of life for poor women as a result of the 1996 welfare reform law Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) (P.L. 104-193). PRWORA ended the long-standing federal welfare entitlement and requires that most welfare recipients work or engage in work-related activities to receive benefits. Welfare caseloads declined by more than half, from 4.55 million families in 1996 to 2.13 million families in 2001 (Brookings Institution, 2002). Although caseloads have increased since the economic down-turn of 2001, they remain well below their pre-welfare reform levels. Research has shown that the transition to work may not be easy for many welfare recipients who face serious barriers to work, including physical and mental health problems (Danziger, Corcoran, et al., 2000; Danziger, Kalil, & Anderson, 2000; Jayakody, Danziger, & Pollack, 2000; Taylor & Barusch, 2004). A study of former and current welfare recipients found that one-third met the diagnostic criteria for major depression, posttraumatic stress disorder (PTSD), and generalized anxiety disorder (Danziger, Corcoran, et al., 2000). Similarly, the National Survey of American Families documented that about one-third of the welfare caseload reported very poor mental or physical health, and four out of 10 recipients had two or more barriers to work (Zedlewski, 2003). Although mental and physical health work barriers are known to reduce work levels among welfare recipients (Danziger, Corcoran, et al., 2000; Danziger & Seefeldt, 2002), not enough is known about the etiology of work barriers. Little attention has been given to how childhood trauma might reverberate throughout women's lives, potentially contributing to work barriers and limited work outcomes in adulthood. Few empirical studies have looked at employment outcomes among women sexually abused as children, although poor women's personal narratives point to childhood sexual abuse (CSA) as an important factor that hinders the ability to obtain and maintain work (Shipler, 2004). To address this gap we examined the prevalence of CSA using data from the Women's Employment Study (WES), a nonclinical, representative sample of current and former welfare recipients. We tested the hypothesis that CSA is negatively related to women's employment outcomes, measured by the percentage of months worked over the 33-month period following enactment of PRWORA. We propose that the connection between CSA and employment is mediated by mental and physical health work barriers that may directly or indirectly result from CSA. We discuss the implications of this study for welfare policy and intervention strategies. CSA PREVALENCE According to the National Comorbidity Study (NCS), a nationally representative study of mental health disorders (Kessler et al., 1994), approximately 13.5% of female respondents retrospectively reported molestation, rape, or both before the age of 18 (Molnar, Berkman, & Buka, 2001). …