"It's Hard to Work When You Are Drunk and in Pain"; How Childhood Trauma Undermines Worker Health, Careers, and Long-Term Economic Well-Being

Background and Purpose: Evidence is mounting on the macro financial costs of childhood trauma (e.g., adverse childhood experiences; ACEs) at the societal or national level. Research is also emerging on how specific types of childhood trauma (e.g., child sexual abuse, CSA) are correlated with poverty, low social-economic-status, or other narrow economic markers at the individual level. To date, most research has used quantitative designs, includes female-majority (or only) samples, and does not take a long-term approach. Guided by the life course perspective, the current qualitative study amplifies worker voices to understand how childhood trauma (e.g., CSA) can affect long-term worker well-being, careers, lifetime savings, and overall economic well-being.

Methods: Analyses were based the 2024 Health and Well-being Survey of Adult Male Survivors (N=321). Data were collected through a one-time, anonymous, 125-item, computer-based survey. One part of the survey included an open-ended question that elicited narrative explanations of any length on how CSA (and other ACEs) may have affected survivor’s health, careers, lifetime savings, and long-term economic well-being. Participants ranged in age from 18 to 74 years (mean = 36.5; S.D. = 14.5); the sample was racially (29.3% Black, Asian, or other) and ethnically diverse (12.8% Latinx). Most participants had a bachelor’s degree or higher (55.3%) and were married/lived with a partner (51.3%), yet two-thirds of the sample (67.3%) had a household income less than $100,000. Guided by grounded theory, two team members analyzed qualitative data over a six-month period using inductive thematic analyses. Several strategies (e.g., immersion, audit trail, inter-coder checks) were used to establish rigor and trustworthiness (Korstjens & Moser, 2018).

Results: Our findings included four major themes of how early trauma impacted worker career, savings, and economic well-being. Participants indicated that CSA: 1) delayed or impeded education (pre-labor preparation), 2) led to undesirable jobs (e.g., low-paying, irregular hours, etc.) or job performance issues (e.g., attendance or concentration problems), 3) subverted career trajectories through chronic under-achievement, disability, premature retirement, or self-sabotage (e.g., job-hopping phenomenon), and 4) contributed to perpetual financial struggles (e.g., living on government assistance, low/no savings, high costs of therapy/treatment). We also identified two mechanisms through which CSA undermined economic well-being: interpersonal struggles (e.g., stigma, conflict with co-workers or authority figures, isolation, antisocial behaviors) and compromised mental health (e.g., distress symptoms, specific disorders such as PTSD or depression, addictions, low esteem). An interesting, surprising finding was that some participants (~ 5%) explained that early trauma boosted their economic well-being by instilling a deep ambition and achievement mindset, leading to successful, distinguished careers.

Conclusions and Implications: Findings support systemic community education efforts to prevent childhood trauma such as CSA. Beyond prevention, more affordable mental health intervention resources should target male survivors and include components on how CSA may indirectly undermine financial health. Vocational, career, and retirement planning services should also be enhanced with this highly vulnerable, stigmatized population. Future research with men can quantify the impact of CSA on lifetime savings and test interventions to disrupt the cycle of child trauma and precarious economic well-being in adulthood.