Breaking the Cycle: Childhood Adversity, Socioeconomic Barriers and Mental Health
- academicmemories
- Jul 18
- 10 min read
Written by: Daisy Draper
Edited by: Jacinda Taggett
During my adolescence, frequent school transfers exposed me to the stark differences in traits between peers from higher-income households versus those with families facing financial hardship and instability. As I advanced in academia, these disparities became even more evident, not only in access to opportunities but also in the trajectory of their mental health and overall well-being.
Fast forward to today, these observations align with a growing body of evidence investigating the interplay between adverse childhood experiences (ACEs) and socioeconomic barriers in shaping mental health outcomes. Adverse childhood experiences are traumatic early-life stressors that can have lasting emotional, physical, and psychological effects (Young-Min Park et al., 2020). Their impacts often extend beyond childhood into adulthood and can shape lifelong health.
It’s safe to say that, as a population, we’ve all encountered some form of adversity. Whether it’s the stress of parental divorce, the social pressures of adolescence, the physiological response to public speaking (seriously, this still traumatizes me), or the widespread disruption of COVID-19. However, ACEs are particularly interesting because they don’t occur randomly. Factors like household income, parental education, and access to resources like healthcare create environments where some individuals are far more likely to experience adversity than others (Fisher et al., 2024).
This raises the question: Why do we so often see people struggling with their mental health also facing financial hardships? Well, these disadvantages don’t just increase the risk of adversity, they shape who is most vulnerable from the very start, creating a systemic cycle of mental health problems.
How Adversity Becomes a Mental Health Problem
I would say we all have a general understanding that traumatic events and perpetual stress in childhood can lead to serious challenges later in life. But what’s more striking is how adversity physically alters the brain, negatively impacting its structure and function. For example, a study using fMRI (a technique measuring activity and structure of the brain) found that ACEs were linked to reduced gray matter in brain areas that help regulate emotions and process social interactions, such as in the frontal, temporal gyri, and the parietal regions (Chang et al., 2023). To help visualize this, think of the gyri as ridges and valleys in a mountainous trail (the ridges and folds in the brain) shaping how we feel by helping us process information and emotions. The parietal lobe is similar to a GPS (just behind the brain's frontal lobe), allowing us to navigate life by interpreting our surroundings and processing sensations. Now think of ACEs as natural disasters (destroying the mountainous trail and throwing off the GPS), therefore altering the brain’s ability to process emotions and engage in psychological resilience, which inevitably alters an individual's ability to cope with stress.
That’s pretty shocking, right? Given that these structural brain changes can impact physical health, it’s no surprise that ACEs are associated with higher rates of mental health problems, such as depression (Humphreys et al., 2020). However, the type of childhood maltreatment modifies the strength of depression, with emotional abuse being most strongly associated with depressive symptoms, such as lack of interest or pleasure in life experiences (Van Veen et al., 2013).
In addition, a recent systematic review analyzed data from over 14 million people globally, revealing that individuals with ACEs are 66% more likely to develop anxiety (Beletew Abate et al., 2024). They also discovered the following:
Certain types of ACEs, like domestic violence, neglect, bullying, or sexual abuse, have the strongest associations with mental illness.
The most common outcomes are depression and anxiety, with depression having an 87% increased risk.
ACEs are a public health issue that requires early intervention to prevent further consequences.
It is important to note that studies are never perfect, and the data used in this review varied by country. This suggests that some outcomes may be influenced by a country’s historical and political context and cultural factors.
Now, what about individuals with genetic predispositions to mental illness? How do we even begin to account for, or confound for, these variables? Gene-environment interaction (GxE) studies help unpack this question. For example, a GxE study conducted in Barcelona used a tool called a polygenic risk score (PRS). A PRS assesses someone’s inherited sensitivity to their environment (essentially, how their genes may make them more or less affected by adversity) to evaluate how their genes interact with ACEs in shaping mental health. They discovered that individuals with higher PRS exhibited the following:
They were more likely to have depression, anxiety, or display psychotic symptoms.
They were less likely to display symptoms if they did not experience adversity.
Some people’s genes interact with ACEs by either magnifying or moderating the impacts (Barrantes-Vidal et al., 2025).
Overall, not everyone with ACEs may experience poor mental health outcomes later in life. That’s because genes are more like a roadmap, they can point to a destination, but it doesn’t mean an individual will arrive there. Whether or not someone develops a mental health condition often depends on the context of their journey, such as the severity or duration of exposure to ACEs. Interestingly, how our genes express is often contextual as well. Factors like poverty, housing instability, and access to resources like healthcare can all shape the trajectory of a person's health. Healthcare disparities are largely explained by adult socioeconomic status (Testa et al., 2022). Suffice it to say, if essential care is out of reach for a large population, mental healthcare is even less accessible, possibly deepening the cycle between adversity, poverty, and mental health risk.
The Relationship Between Adversity, Socioeconomic Barriers & Mental Health
Research also suggests that socioeconomic status is a key factor in shaping childhood adversity. Take, for example, a longitudinal UK study that tracked over 8,000 children from birth through adolescence to explore how growing up in poverty influenced their exposure to ACEs. The researchers found the following:
Children born into poverty were almost 5x more likely to grow up in households with violence, addiction, and family conflict.
Children in low-income families face a significantly higher risk of early childhood abuse.
Poverty actively shaped who experienced ACEs and how severe they became (Farooq et al., 2024).
Here’s the reality, when resources are limited, so are the options for improving difficult situations. Financial instability makes it harder to escape chronic stress, and socioeconomic barriers often keep individuals trapped in cycles of adversity. Additionally, think about one’s housing options when enduring poverty. This may also further exacerbate their challenges, exposing them to environments that increase the likelihood of experiencing mental health issues. However, those from higher-income households are less likely to experience higher numbers of ACEs, as those with financial security have more options when navigating adversity with fewer long-term consequences (Merrick et al., 2018).
We’ve all heard the rhetoric of ‘pulling yourself up by the bootstraps’ when it comes to navigating hardship, but is that a reality for most people? While it may work for some, society often underestimates the lasting toll of traumatic events on people’s lives. It doesn’t just create obstacles, because it stacks the deck against you, especially regarding our youth and their educational achievement. Socioeconomic barriers can determine the quality of children's schooling, and persistent adversity may further hinder their academic performance.
Let’s take a closer look at how ACEs may influence success. One study from 2023 tracked over 300 individuals at high risk for psychosis to examine how ACEs shaped their education and employment over time. The findings revealed:
Childhood trauma, specifically emotional abuse, is linked to lower educational attainment.
Adversity shrinks opportunities, as ACEs increase the likelihood of dropping out and struggling to earn higher qualifications.
The impact extends beyond school, as those who experience physical abuse are more likely to be unemployed, while emotional neglect is linked to early workforce entry, possibly out of necessity and likely hindering the pursuit of higher education (Tognin et al., 2023).
However, these findings should be read with caution, as they examined a smaller sample size and focused on individuals at high risk for psychosis, which limits how broadly these findings apply to the general population. More research is needed to see if these patterns apply to a wider demographic. Nonetheless, we can begin to see how the cycle unfolds.
To take matters further, marginalized groups are often more likely to experience ACEs and mental health issues. According to a grounded theory analysis, researchers interviewed over 80 health and education providers, finding that race and poverty significantly shaped childhood adversity. They also identified that racism and chronic poverty created conditions where ACEs were more likely to occur, and that resources for assistance were often difficult to access (Camacho et al., 2022). This correlation aligns with recent literature, as multiracial individuals experience 46% higher rates of ACEs compared to white individuals (Giano et al., 2024). Overall, these findings underscore the significance of systemic inequities in shaping childhood adversity. Socioeconomic inequities don’t just create adversity. They are reinforced by systems that keep people stuck, setting them up for failure from the start.
Evidence-Based Ways to Create Positive Change
ACEs not only impact mental health, but they also cause a significant economic burden on our nation. ACEs cost the U.S. economy approximately $14.1 trillion each year due to lost healthy-life years and medical costs (Peterson et al., 2023). So, how do we break the cycle, and what are some evidence-based interventions that can help alleviate the impacts of ACEs caused by social and economic factors? The CDC offers key strategies for improvement (CDC and Prevention, 2019):
Shift social norms around parenting - Community education campaigns can reduce the stigma around seeking help, helping to promote shared responsibility for children’s safety.
Tax Credits - Implementing tax credits, such as the Child Tax Credit, can increase family income, reduce poverty, and alleviate parental stress. These credits have been linked to an overall improvement in children’s health and behavioral problems.
Childcare Subsidies - Providing subsidies to help alleviate childcare costs can help families access higher levels of care. These subsidies are proven to reduce childhood abuse and neglect and reduce the rate of maternal depression.
Paid Family Leave - Paid family and medical leave ensures better care for children without income loss. These policies are associated with higher maternal employment and improved child development.
Flexible Work Schedules - Mandating employers to provide flexibility in scheduling can help parents balance work and family responsibilities, thus reducing stress and improving family interactions.
State Dependent Care Tax Credits - Mandating states to implement tax credits to supplement federal assistance can help low-income families with childcare expenses. These credits can vary in eligibility.
Developmental Block Grants - Federal grants can provide funds to states to help with childcare costs while parents attend work or higher education.
These policies highlight myriad ways our nation can help reduce the long-term impacts of ACEs by creating safe, stable, equitable, and nurturing environments for children. ACEs are a public health issue, and I hope this article helped illuminate the urgent need to build stronger systems that support families, because that’s how we foster a healthier, more resilient, and mentally healthy society.
References:
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