Association between child sexual abuse and mid-life employment earnings.

ImportanceIndividuals who have been sexually abused are at a greater risk for poor health, but associations with economic outcomes in mid-life have been overlooked. ObjectivesWe investigated associations between child sexual abuse ([≤]18 years) and economic outcomes at 33-37 years, while considering type of report (official/retrospective) and characteristics of abuse (type, severity, and chronicity). DesignThis cohort study used data collected for the Quebec Longitudinal Study of Kindergarten Children. SettingThe Quebec Longitudinal Study of Kindergarten Children is a population-based sample. ParticipantsParticipants were 3,020 boys and girls attending kindergarten in the Canadian Province of Quebec in 1986/88 and followed up until 2017. Main outcome/MeasuresChild sexual abuse (0-18 years old) was assessed using both retrospective self-report questionnaires and objective reports (notification to Child Protection Services). Information on employment earnings was obtained from government tax return records. Tobit regressions were used to test associations of sexual abuse with earnings adjusting for sex and family socioeconomic background. ResultsOf the 3,020 participants 1,320 [43.7%] self-reported no sexual abuse, 1,340 [44.3%] had no official report but were missing on the retrospective questionnaire, 340 [11.3%] reported retrospective sexual abuse, and 20 [0.7%] had official report. In the fully adjusted model, individuals who retrospectively reported being sexually abused earned US$4,031 (CI=-7,134 to -931) less per year at age 33-37 years, while those with official reports earned US$16,042 (CI=-27,465 to -4,618) less, compared to participants who were not abused. Among individuals with retrospectively reported abuse, those who experienced intra-familial abuse earned US$4,696 (CI=-9,316 to -75) less than individuals who experienced extra-familial abuse, while participants who experienced penetration earned US$6,188 (CI=-12,248 to -129) less than those who experienced non-contact abuse. Conclusion and RelevanceChild sexual abuse puts individuals at risk for lasting reductions in employment earnings in adulthood. Early identification and support for sexual abuse victims could help reduce the economic gap and improve long-term outcomes. Key PointsO_ST_ABSQuestionC_ST_ABSIs child sexual abuse associated with lower mid-life employment earnings? FindingsIn a large population-based cohort (n=3,020), children exposed to sexual abuse had lower annual employment earnings from age 33-37 years than children nonexposed, after adjustment for childhood socioeconomic circumstances. These differences were more pronounced for individuals with official Child Protection Service reports compared to those with retrospective reports, and for individuals who experienced more severe forms of sexual abuse (i.e., penetration, intra-familial). MeaningChildren exposed to sexual abuse are at risk of poor socioeconomic outcomes in mid-adulthood; interventions and support to improve long-term economic participation should be considered.