The influence of childhood welfare participation on adulthood substance use: evidence from the National Longitudinal Study of Adolescent to Adult Health

ABSTRACT

Background: The associations between early life-socioeconomic status and health, specifically substance use, are well substantiated. The vulnerabilities associated with adversity in childhood, particularly poverty, can have a cumulative effect on an individual’s risk and resilience throughout the life course. While several studies substantiate the relationship between substance use and welfare participation, less known is the impact of and prevalence of behavioral health problems later in life among young adults who were welfare recipients before age 18. Objective: This article explores whether childhood welfare participation before the age of 18 years influences substance use until young adulthood (24–34 years). Methods: This study used Add Health data with sample sizes ranging from 12,042 to 12,324 respondents, and propensity score matching methods to balance the samples and account for selection bias. Matched data were then used to run a series of regression models. Results: Those who participated in welfare before the age of 18 years had a significant lower probability of remaining substance-free until young adulthood (marijuana-free by 30%, p < 0.001; and other illicit substances-free by 16%, p < 0.05). However, no significant between-group differences were found on any of the alcohol-related variables. Conclusions: Findings highlight long-term behavioral health risks, especially substance use, faced by young adults who participated in welfare before the age of 18 years. Acknowledging the vulnerabilities associated with welfare participation and living in poverty could help increase the effectiveness of program and treatment efforts. The prevention of long-term behavioral health disorders hinges on early diagnosis and intervention.

KEYWORDS:

• Welfare participation
• substance use
• drug use
• alcohol use
• propensity score matching
• Add Health

Acknowledgements

This research uses data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill. The authors particularly thank Kathleen Mullan Harris and Mark W. Fraser for assistance with the access of restricted data and original design. Information on how to obtain Add Health data is available on the Add Health website (http://www.cpc.unc.edu/addhealth).

Funding

This research was funded by Grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 23 other federal agencies and foundations. No direct support was received from Grant No. P01-HD31921for this analysis.

Additional information

Funding

This research was funded by Grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 23 other federal agencies and foundations. No direct support was received from Grant No. P01-HD31921for this analysis.