Her father, Revd Thomas Macadam, was a minister in the Free Church of Scotland, and her mother, his wife, was Elizabeth Whyt.
Following the death of her mother and the retirement of her father, Elizabeth and her sister Margaret returned to Scotland as young women.
In 1898 Macadam was awarded a Pfeiffer scholarship and trained in social work at the Women's University Settlement in Southwark, London.
During the four years that she spent at the settlement, Macadam helped to run an evening school for approximately hundred adolescent boys and girls.
In 1916, and at the request of the Ministry of Munitions, Macadam helped to devise training courses for welfare workers.
[3] At the end of the First World War, Macadam and Eleanor Rathbone bought a house together and moved to 50 Romney Street, London.