Abstract
Purpose
This 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.
Methods
Data 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.
Results
Family 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.
Discussion
Findings 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.
Keywords
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Article info
Publication history
Published online: February 04, 2022
Accepted:
November 10,
2021
Received:
May 12,
2021
Footnotes
Conflicts of interest: There are no potential conflicts, real or perceived, for any named author.
Identification
Copyright
© 2021 Society for Adolescent Health and Medicine. All rights reserved.
