A decade lost: does educational success mitigate the increased risks of premature death among children with experience of out-of-home care?

Almquist, Ylva B.; Jackisch, Josephine; Forsman, Hilma; Gauffin, Karl; Vinnerljung, Bo; Hjern, Anders; Brännström, Lars

doi:10.1136/jech-2018-210487

Cited by 21 publications

(13 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For example, an earlier study based on the SBC Multigen found that above-average school performance counteracted the increased risks for premature mortality among individuals with childhood experiences of out-of-home care. 24 Another study, drawing on information from the Northern Swedish cohort, found that adversity during adolescence was less strongly associated with having poorer self-rated health in midlife among individuals who had an advantaged situation with regard to school, peers or spare time. 25…”

Section: Discussionmentioning

confidence: 99%

Intergenerational transmission of alcohol misuse: mediation and interaction by school performance in a Swedish birth cohort

Almquist

Bishop

Gustafsson

et al. 2020

J Epidemiol Community Health

Self Cite

View full text Add to dashboard Cite

BackgroundChildren whose parents misuse alcohol have increased risks of own alcohol misuse in adulthood. Though most attain lower school marks, some still perform well in school, which could be an indicator of resilience with protective potential against negative health outcomes. Accordingly, the aim of this study was to examine the processes of mediation and interaction by school performance regarding the intergenerational transmission of alcohol misuse.MethodsData were drawn from a prospective Swedish cohort study of children born in 1953 (n=14 608). Associations between parental alcohol misuse (ages 0–19) and participants’ own alcohol misuse in adulthood (ages 20–63) were examined by means of Cox regression analysis. Four-way decomposition was used to explore mediation and interaction by school performance in grade 6 (age 13), grade 9 (age 16) and grade 12 (age 19).ResultsMediation and/or interaction by school performance accounted for a substantial proportion of the association between parental alcohol misuse and own alcohol misuse in adulthood (58% for performance in grade 6, 27% for grade 9 and 30% for grade 12). Moreover, interaction effects appeared to be more important for the outcome than mediation.ConclusionAbove-average school performance among children whose parents misused alcohol seems to reflect processes of resilience with the potential to break the intergenerational transmission of alcohol misuse. Four-way decomposition offers a viable approach to disentangle processes of interaction from mediation, representing a promising avenue for future longitudinal research.

show abstract

Section: Discussionmentioning

confidence: 99%

Intergenerational transmission of alcohol misuse: mediation and interaction by school performance in a Swedish birth cohort

Almquist

Bishop

Gustafsson

et al. 2020

J Epidemiol Community Health

Self Cite

View full text Add to dashboard Cite

show abstract

“…Future studies should aim at explaining the remaining part of the association by considering other indicators of disadvantage, measured from adolescence and onwards, such as behavioural problems, poor housing, somatic ill-health, low general well-being, early childbearing and family disruption, and poor educational attainment. In particular, past research has identified educational failure as a fundamental explanation for the adverse long-term outcomes of child welfare clients [9, 21–23].…”

Section: Discussionmentioning

confidence: 99%

“…In Sweden, the context of the current study, a core aim of OHC placement is also to provide the child with better opportunities for development [2]. Yet, prior research has consistently identified children with experience of OHC as a high-risk group for premature mortality [3–9], the perhaps most readable indicator of health inequality.…”

Section: Introductionmentioning

confidence: 99%

Do trajectories of economic, work- and health-related disadvantages explain child welfare clients’ increased mortality risk? A prospective cohort study

Almquist

Brännström

2019

BMC Public Health

Self Cite

View full text Add to dashboard Cite

Background Past research has shown that individuals who have had experiences of out-of-home care (OHC) in childhood have increased risks of premature mortality. Prior studies also suggest that these individuals are more likely to follow long-term trajectories that are characterised by economic, work-, and health-related disadvantages, compared to majority population peers. Yet, we do not know the extent to which such trajectories may explain their elevated mortality risks. The aim of this study is therefore to examine whether trajectories of economic, work-, and health-related disadvantages in midlife mediate the association between OHC experience in childhood and subsequent all-cause mortality. Methods Utilising longitudinal Swedish data from a 1953 cohort ( n = 14,294), followed from birth up until 2008 (age 55), this study applies gender-specific logistic regression analysis to analyse the association between OHC experience in childhood (ages 0–19; 1953–1972) and all-cause mortality (ages 47–55; 2000–2008). A decomposition method developed for non-linear regression models is used to estimate mediation by trajectories of economic, work-, and health-related disadvantages (ages 39–46; 1992–1999), as indicated by social welfare receipt, unemployment, and mental health problems. To account for selection processes underlying placement in OHC, an alternative comparison group of children who were investigated by the child welfare committee but not placed, is included. Results The results confirm that individuals with experience of OHC have more than a two-fold increased risk of all-cause mortality, for men (OR: 2.10, 95% CI: 1.42–3.11) and women (OR: 2.23, 95% CI: 1.39–3.59) alike. Approximately one-third (31.1%) of the association among men, and one-fourth (27.4%) of the association among women, is mediated by the long-term trajectories of economic, work-, and health-related disadvantages. The group who were investigated but not placed shows similar, yet overall weaker, associations. Conclusions Individuals who come to the attention of the child welfare services, regardless of whether they are placed in out-of-home care or not, continue to be at risk of adverse outcomes across the life course. Preventing them from following trajectories of economic, work-, and health-related disadvantages could potentially reduce their risk of premature death.

show abstract

“…In a Danish study, the mortality risk was approximately three times higher in the OHC population compared to peers in the majority population at the age of 27, with adjustment for parental background factors including psychiatric disorders, substance misuse, educational attainment, and unemployment (Nygaard Christoffersen 1999). Almquist et al (2018) found that the OHC population lost almost a decade in life expectancy between the ages of 20 and 56 in comparison to peers in the majority population without OHC experience, and that school failure was strongly associated with the excess mortality. Evidence suggests that the risk factors for school failure and excess mortality are similar and intertwined with, for instance, behavioural disorders, substance misuse, and mental health problems including suicidal behaviour (Manninen et al 2015;Nygaard Christoffersen 1999;Hjern, Vinnerljung, and Lindblad 2004;Kalland et al 2001;Berlin, Vinnerljung, and Hjern 2011).…”

Section: Previous Research On Predictors Of Mortality In the Ohc Popumentioning

confidence: 99%

The relation between out-of-home care, early school failure, and premature mortality: a 30-year follow-up of people treated for substance misuse in Sweden

Berlin

Greiff

Skogens

2020

Nordic Social Work Research

View full text Add to dashboard Cite

Evidence from Swedish and international studies show that a high proportion of children from out-of-home care (OHC) have poor school performance and that this is strongly associated with their substantial risk of adverse development in future life. However, risk factors for poor school performance and adverse development are difficult to disentangle since they are often interrelated and enforce each other over the life course. This study examines premature mortality in relation to early school failure (drop-out from compulsory school) and OHC experience in childhood (0-17 years of age) among clients who were in treatment for substance misuse in the early 1980s (N = 1,036). The analyses were based on record linkages between interview data collected during treatment and national register data covering approximately 30 years of follow-up, from exit from treatment until 2013. Our results showed that 54 per cent had been placed in OHC as children, half before their teens and half as teenagers. The OHC population had a higher prevalence of school failure compared with clients who had not been exposed to childhood OHC. OHC was associated with an excess mortality, although this was only significant for females who had entered OHC before their teens. Adjusting results for school failure reduced their excess mortality by half, and additional life course factors associated with mortality among people with substance misuse adjusted for most of the remaining excess mortality. School failure was strongly associated with the excess mortality of females, but not with the excess mortality of males.

show abstract

A decade lost: does educational success mitigate the increased risks of premature death among children with experience of out-of-home care?

Cited by 21 publications

References 38 publications

Intergenerational transmission of alcohol misuse: mediation and interaction by school performance in a Swedish birth cohort

Intergenerational transmission of alcohol misuse: mediation and interaction by school performance in a Swedish birth cohort

Do trajectories of economic, work- and health-related disadvantages explain child welfare clients’ increased mortality risk? A prospective cohort study

The relation between out-of-home care, early school failure, and premature mortality: a 30-year follow-up of people treated for substance misuse in Sweden

Contact Info

Product

Resources

About