School Outcomes Among Children Following Death of a Parent

Abstract

IMPORTANCETo better support children with the experience of parental death, it is crucial to understand whether parental death increases the risk of adverse school outcomes.OBJECTIVES To examine whether parental death is associated with poorer school outcomes independent of factors unique to the family, and whether children of certain ages are particularly vulnerable to parental death. DESIGN, SETTING, AND PARTICIPANTSThis population-based sibling cohort study used Swedish national register-based longitudinal data with linkage between family members. Register data were collected from January 1, 1990, to December 31, 2016. Data analyses were performed on July 14, 2021. The participants were all children born between 1991 and 2000 who lived in Sweden before turning age 17 years (N = 908 064). EXPOSURE Parental death before finishing compulsory school. MAIN OUTCOMES AND MEASURES Mean school grades (year-specific z scores) and ineligibility for upper secondary education on finishing compulsory school at age 15 to 16 years. Population-based cohort analyses were conducted to examine the association between parental death and school outcomes using conventional linear and Poisson regression models, after adjustment for demographic and parental socioeconomic and health indicators measured before childbirth. Second, using fixed-effect linear and Poisson regression models, children who experienced parental death before finishing compulsory school were compared with their siblings who experienced the death after. Third, the study explored the age-specific associations between parental death and school outcomes. RESULTS In the conventional population-based analyses, bereaved children (N = 22 634; 11 553 boys [51.0%]; 11 081 girls [49.0%]; mean [SD] age, 21.0 [2.8] years) had lower mean school grade zscores (adjusted β coefficient, −0.19; 95% CI, −0.21 to −0.18; P < .001) and a higher risk of ineligibility for upper secondary education than the nonbereaved children (adjusted risk ratio, 1.36; 95% CI, 1.32-1.41; P < .001). Within-sibling comparisons using fixed-effects models showed that experiencing parental death before finishing compulsory school was associated with lower mean school grade z scores (−0.06; 95% CI, −0.10 to −0.01; P = .02) but not with ineligibility for upper secondary education (adjusted risk ratio, 1.07; 95% CI, 0.93-1.23; P = .34). Independent of birth order, losing a parent at a younger age was associated with lower grades within a family. CONCLUSIONS AND RELEVANCEIn this cohort study, childhood parental death was associated with lower school grades after adjustment for familial confounders shared between siblings. Children who lost a parent may benefit from additional educational support that could reduce the risk of adverse socioeconomic trajectories later in life.

Implications for School Practices of the Association of Child Bereavement With School Grades

“…This study strengthens the evidence base for an association between death of a parent and lower school grades by a very clever use of sibling data to control for the influence of family environment, as well as controlling for other potential confounders. In addition, the fact that the findings are from a population-based longitudinal cohort study heightens the importance of the study.…”

“…It would be interesting to learn about other health and mental health outcomes experienced by the parentally bereaved children in this study. 1 This study's findings concerning subgroup differences in the association of parental death with school grades are difficult to interpret. 1 Why would there be larger associations with school grades for paternal rather than maternal death or natural causes of death rather than death by accident or suicide?…”

“…1 This study's findings concerning subgroup differences in the association of parental death with school grades are difficult to interpret. 1 Why would there be larger associations with school grades for paternal rather than maternal death or natural causes of death rather than death by accident or suicide? What explains the inconsistent findings between age at the time of death and magnitude of association between bereavement and school grades?…”

“…The findings from this study 1 need to be put in the context of evidence that parentally bereaved children are at elevated risk for multiple mental health problems 3 and impaired developmental competencies. 4 The association of parental death with school grades is only 1 lens through which to view how parental death impairs children's healthy development, but it is an important one.…”

“…The study by Liu et al is of particular interest at this time when the world is experiencing an upsurge of child bereavement from the death of a parent due to the COVID-19 pandemic . The questions of highest scientific and public health interest are as follows: What is the impact of parental death on children?…”