TY - JOUR
T1 - Adverse childhood experiences and adolescent drug use in the UK
T2 - The moderating role of socioeconomic position and ethnicity
AU - Karamanos, A.
AU - Stewart, K.
AU - Harding, S.
AU - Kelly, Y.
AU - Lacey, R. E.
N1 - Funding Information:
Socio-economic position was captured using a combination of parental education, family income and parental social class. Highest parental educational qualifications were measured at MCS 6 (National Vocational Qualifications (NVQ) 4/5, NVQ 3, NVQ 2, NVQ 1, Overseas, None). Parental education encompasses a range of non-economic social attributes such as general and health-related knowledge, literacy, problem-solving skills, and prestige that are associated with ACEs and drug use (Galobardes et al., 2004; Straatmann et al., 2020). We also tried to measure socio-economic position in a way that captures wider inequalities, using both family income and parental social class. Family income in the MCS is calculated as the total family income from all sources after tax and before housing costs. It is then adjusted for family size and composition using the modified OECD equivalence scale. Equivalised family income was averaged over the first six available surveys and then divided into fifths (quintiles), rather than using a dichotomy between poor and non-poor households. Parental social class was measured using the National Statistics-Socio-Economic Classification (NS-SEC) occupational schema. Parental social class as a measure of socio-economic disadvantage goes beyond income to capture longer-term economic security, stability, and prospects, as reflected in a person's labour market position. It also reflects power in terms of relationships of authority, command, control, and autonomy within the workplace (Bartley, 2016). Parental social class was based on the highest maternal and partner social class over the first six available MCS surveys according to NS-SEC 5 (managerial, professional, small employed and self-employed, supporting, and technological, semi routine, and routine). NS-SEC was used to maximise the comparability of the current article with wider research using social class as a measure of socio-economic advantage/disadvantage.The datasets supporting the conclusions of this article are available via the UK Data Service, subject to their end-user license agreement, from the University of Essex (University of London IoE, 2018, p. 8682; University of London IoE, 2003–2005, p. 5350; University of London IoE, 2001–2003, p. 4683; University of London IoE, 2006, p. 5795; University of London IoE, 2008, p. 6411; University of London IoE, 2012, p. 7464; University of London IoE, 2015, p. 8156).Developing policies to tackle these factors is not straightforward. In an exploration of early intervention policies in 2016, the Early Intervention Foundation (EIF) found no interventions which demonstrated effectiveness in addressing sexual abuse (Intervention Foundation, 2018). Sexual violence usually takes place in unsupervised spaces, such as parties or parks without adults present (Ofsted, 2021). Nonetheless, schools may have a special role in preventing sexual abuse from occurring, as well as in tackling bullying. In two recent reports, the Children's Commissioner and the Office for Standards in Education (Ofsted) highlighted the important role of schools as a context for prevention of sexual assault through Personal, Social, Health and Economic education (PHSE) and relationships and sex education (RSE), and through the availability of trusted adults and emotional and pastoral support within the school environment (Ofsted, 2021; Children's Commisioner, 2017). In addition, the Children's Commissioner recommended that PHSE and compulsory relationships and sex education in schools can create opportunities to develop a culture where all kinds of sexual harassment and abuse are recognised and addressed. Further, schools could be an environment where staff model respectful and appropriate behaviour, where children and young people are clear about what is acceptable and unacceptable behaviour, and where they are confident to ask for help and support when they need it (Children's Commisioner, 2017). Our findings show that exposure to sexual violence, bullying and violence within the household, has knock-on consequences on wider aspects of young people's lives, whatever their social, ethnic, or economic background, adding further urgency to the need to reduce the incidence of these negative experiences.AK & SH were supported by the Medical Research Council (MR/R022739/1) and REL by the Economic and Social Research Council (ES/P010229/1).
Funding Information:
AK & SH were supported by the Medical Research Council ( MR/R022739/1 ) and REL by the Economic and Social Research Council ( ES/P010229/1 ).
Publisher Copyright:
© 2022
PY - 2022/9
Y1 - 2022/9
N2 - Rationale: There is a paucity of prospective UK studies exploring the role of Adverse Childhood Experiences (ACEs) on adolescent teenage drug use and even less is known about the complex interplay between ACEs and adolescent social, demographic, and economic characteristics. To address these gaps, we use rich longitudinal data from the nationally representative Millennium Cohort Study. Methods: Sex-stratified survey logistic regression modelling was applied using data from 9,476 adolescents and their parents to examine associations between ACEs between ages 3 and 14 years and drug use at ages 14 and 17 years. We a) explore the extent to which associations are robust to adjustment for ethnicity, family income, parental social class, and parental education, b) examine whether associations differ by these factors, and c) estimate the proportion of drug use at ages 14 and 17 years attributable to ACEs after controlling for these factors. Results: Half of MCS cohort members had been exposed to at least one ACE and approximately 1 in 11 were exposed to 3+ ACEs. Multivariable analyses suggest that ACEs were associated with a higher likelihood of drug use at age 14 than age 17, especially for girls. No evidence was found that either advantaged socio-economic position or ethnicity acted as a buffer against the negative effects of ACEs in relation to adolescent drug use. Finally, we found that prevention of exposure to sexual violence, bullying and violence within the household (if causal) is more important for girls’ drug use at age 14 than age 17. Conclusions: ACEs are associated with adolescent drug use with potential consequences on wider aspects of young people's lives, regardless of their social, ethnic, or economic background, adding further urgency to the need to reduce the incidence of these negative experiences.
AB - Rationale: There is a paucity of prospective UK studies exploring the role of Adverse Childhood Experiences (ACEs) on adolescent teenage drug use and even less is known about the complex interplay between ACEs and adolescent social, demographic, and economic characteristics. To address these gaps, we use rich longitudinal data from the nationally representative Millennium Cohort Study. Methods: Sex-stratified survey logistic regression modelling was applied using data from 9,476 adolescents and their parents to examine associations between ACEs between ages 3 and 14 years and drug use at ages 14 and 17 years. We a) explore the extent to which associations are robust to adjustment for ethnicity, family income, parental social class, and parental education, b) examine whether associations differ by these factors, and c) estimate the proportion of drug use at ages 14 and 17 years attributable to ACEs after controlling for these factors. Results: Half of MCS cohort members had been exposed to at least one ACE and approximately 1 in 11 were exposed to 3+ ACEs. Multivariable analyses suggest that ACEs were associated with a higher likelihood of drug use at age 14 than age 17, especially for girls. No evidence was found that either advantaged socio-economic position or ethnicity acted as a buffer against the negative effects of ACEs in relation to adolescent drug use. Finally, we found that prevention of exposure to sexual violence, bullying and violence within the household (if causal) is more important for girls’ drug use at age 14 than age 17. Conclusions: ACEs are associated with adolescent drug use with potential consequences on wider aspects of young people's lives, regardless of their social, ethnic, or economic background, adding further urgency to the need to reduce the incidence of these negative experiences.
KW - ACEs
KW - Adolescence
KW - Adverse childhood experiences
KW - Adversity
KW - Drug use
UR - http://www.scopus.com/inward/record.url?scp=85132216288&partnerID=8YFLogxK
U2 - 10.1016/j.ssmph.2022.101142
DO - 10.1016/j.ssmph.2022.101142
M3 - Article
AN - SCOPUS:85132216288
SN - 2352-8273
VL - 19
JO - SSM - Population Health
JF - SSM - Population Health
M1 - 101142
ER -
