The Lasting Consequences of Childhood Sexual Abuse on Human Capital

Background: Childhood sexual abuse is a public health crisis. Meta-analyses collectively covering all continents show that childhood sexual abuse is a worldwide problem and suggest that the global prevalence is 15 to 20 percent among females and 8 percent among males. Meanwhile, scientists posit neurobiological mechanisms explaining effects of chronic childhood stress on physiological systems and cognitive development. While childhood sexual abuse directly impacts a great number of people, we know little about the causal impacts on survivors beyond the immediate trauma. A main barrier to research in this area has been a lack of longitudinal, individual-level data identifying survivors of sexual abuse and difficulty overcoming contamination from selection. Here, I examine whether there are durable effects of childhood sexual abuse on human capital—a largely neglected area of well-being of survivors of sexual trauma.

Data and methods: I use the National Longitudinal Study of Adolescent to Adult Health (Add Health), which followed a nationally representative sample of about 15,000 individuals from middle school through adulthood. Add Health includes self-interview questions on contact sexual abuse in childhood along with a rich set of information on childhood socioeconomic status, neighborhood factors, and school identifiers. To study the effects of childhood sexual abuse on education and labor market outcomes, I employ fixed effects strategies, implement partial identification methods for bounding treatment effects, and conduct direct tests of selection. I present main results from school fixed effects regression and from bounding methods developed by Oster (2017), Altonji, Elder, and Taber (2002) to examine robustness of results to varying assumptions about remaining selection on unobservables, using information on selection on observables. In ancillary analyses, I conduct sibling conditional fixed effect regression. I also test whether there were pre-existing difference in cognitive ability, using scores from a picture vocabulary test.

Results: In this nationally representative US sample, 21 percent of women and 8 percent of men noted history of contact sexual abuse in childhood. Results from the bounding exercise suggest that childhood sexual abuse leads to 7 to 9 percent lower likelihood of high school diploma receipt, 20 to 28 percent lower likelihood of college degree attainment, 4 to 8 percent lower likelihood of full-time employment, and 11 to 18 percent lower earnings. Results suggest that the effect of childhood sexual abuse on likelihood of college degree attainment is smaller for Hispanics and Blacks than for Whites. I do not detect any pre-existing differences in cognitive ability across those who did not experience childhood sexual abuse and those who later reported childhood sexual abuse.

Conclusions and policy impact: Childhood sexual abuse causes lower educational attainment and worse labor market outcomes in adulthood. This study has important implications for public health and public policy, highlighting the importance of detection and quality treatment of trauma symptoms. In particular, results suggest that only treating the mental health symptoms of survivors of childhood sexual abuse is not enough to reduce disparities in well-being.