The Impact of Adverse Childhood Experiences on Socioeconomic Status in Adulthood: A Scoping Review

Background and Purpose: Abundant evidence has demonstrated that exposure to ACEs is associated with adverse physical and mental health outcomes, as well as increased engagement in risk behaviors. More recently, research has also highlighted the impact of ACEs on socioeconomic outcomes, showing that ACEs can reduce life opportunities and hinder long-term economic stability. However, no comprehensive synthesis has systematically summarized this association. This study aimed to conduct a scoping review on ACEs and adult socioeconomic outcomes, mapping the existing research, identifying key gaps, and highlighting directions for future research and practice.

Methods: This study was guided by Arksey and O'Malley (2005)'s methodological framework. Seven databases were searched: PubMed, APA PsycArticles (EBSCOhost platform), APA PsycInfo (EBSCOhost), CINAHL (EBSCOhost), Social Services Abstracts (ProQuest platform), Social Work Abstracts (ProQuest), and Sociological Abstracts (ProQuest). Additionally, Google Scholar was used as a complementary search source to identify articles not indexed in the selected databases. The following inclusion criteria were applied: (1) English language; (2) Peer-reviewed articles; (3) Studies with a cumulative measure of at least four ACEs; (4) Studies of the impacts of ACEs on education, employment, or income in adulthood.

Results: Our search generated 1946 articles. After the screening of two independent reviewers, 39 articles were identified for this scoping review. All the 39 articles were published between 2003 and 2024, encompassing studies conducted in 13 countries. Findings from the review highlight that individuals with higher levels of ACEs were more likely to experience unemployment and an increased risk of work disability in adulthood. Additionally, ACEs significantly heightened the risk of poverty, with financial difficulties accumulating throughout the life course. Furthermore, individuals exposed to multiple ACEs demonstrated lower completion rates for high school and college, notably affecting timely college graduation. Overall, elevated exposure to ACEs directly predicted lower socioeconomic status in adulthood. Finally, this review study also found that health-related factors such as diabetes, heart disease, obesity, depression, and substance use mediated the relationship between ACEs and socioeconomic outcomes in adulthood, while factors like gender, educational qualifications, and depression moderated this relationship.

Conclusions and Implications: This scoping review indicates that cumulative ACEs exposure significantly compromises educational attainment, employment stability, and income levels, perpetuating cycles of poverty and economic disadvantage throughout individuals' lives. The findings highlight several critical implications for future research, policy, and practice. First, there is a need for longitudinal research into intergenerational impacts, specifically how parental ACEs histories influence their children's socioeconomic trajectories. Particular attention should be given to indigenous and minority populations, who disproportionately experience ACEs and their economic consequences. Second, future studies should identify protective factors and resilience-promoting interventions capable of mitigating ACEs’ long-term socioeconomic harms. By emphasizing preventative strategies and targeted support, stakeholders can disrupt the intergenerational cycle of adversity and economic disadvantage, ultimately promoting equitable life opportunities and enhanced well-being. Finally, comprehensive, trauma-informed interventions and early childhood policies are essential for preventing or significantly reducing ACE exposure. Policymakers and practitioners should prioritize evidence-based programs and supportive educational environments to build resilience and socioeconomic mobility among affected groups.