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Black men who witnessed a shooting before turning 12 have household earnings as adults 31 percent lower than those who did not. We present evidence that this gap is causal and is most likely the result of toxic stress; it is not mediated by incarceration and is constant across neighborhood socioeconomic status. Turning to mechanisms related to toxic stress, we study exposure to violence and nurturing relationships during adolescence. Item-anchored indexes synthesize variables on these treatments better than summing positive responses, Item Response Theory, or Principal Components, which all perform similarly. Providing adolescents with nurturing relationships is almost as beneficial as preventing their exposure to violence. [ABSTRACT FROM AUTHOR]