Examining Economic Risks in Adolescents’ Families, Neighborhoods, and Schools: Implications for Mental and Behavioral Health in Early Adulthood

Abstract

PurposeThis study assessed long-term links among adolescent family, neighborhood, and school economic contexts and mental and behavioral health in early adulthood, irrespective of adult economic contexts. MethodsData were drawn from Add Health, following 10,180 participants from adolescence through early adulthood in the United States. Early adults self-reported on their depressive symptoms, perceived psychological stress, and alcohol use disorder. Income at family and school levels was drawn from youth and parent report; neighborhood income was derived from US Census Data. Multilevel models assessed associations between income in adolescence and early adult outcomes 13 years later while accounting for adolescent outcomes and income in early adulthood. Links with depressive symptoms and stress were assessed utilizing ordinary least squares regression; alcohol use disorder was assessed using ordered logistic regression. Nonlinearities in income effects were assessed with quadratic income variables in adolescence and early adulthood. ResultsFamily income emerged as the most consistent predictor of depressive symptoms (p < .01) and stress (p < .01), showing negative curvilinear associations. In contrast, exposure to higher income schools (p < .01) and neighborhoods (p < .01) during adolescence was associated with heightened risks for alcohol use disorder in early adulthood. These links emerged over and above concurrent negative connections between early adult family and neighborhood economic contexts and depressive symptoms and stress. DiscussionFindings call attention to persistent health-related risks across the income spectrum—not only at the lower end—and also highlight the long-term importance of broader economic contexts beyond the family context.