State care in childhood and adult mortality: a systematic review and meta-analysis of prospective cohort studies

Batty, G. David; Kivimäki, Mika; Frank, Philipp

doi:10.1016/s2468-2667(22)00081-0

Cited by 21 publications

(27 citation statements)

References 76 publications

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“…In secondary analyses, we found support for the observation that men and women with a care history had markedly elevated risk of total mortality in adulthood. 1 Similarly, we were able to recapitulate known associations for our mediating variables in relation to later CVD, such as cigarette smoking, 19,20 low educational achievement, 21,22 and early age at first birth. 23 These findings therefore give us a degree of confidence in our the new results for care and later CVD.…”

Section: Discussionmentioning

confidence: 67%

“…The use of registry data on state care is particularly important relative to the alternative of asking study members to respond to enquiries on issue as sensitive as childhood separation from one’s biological family that could have occurred many decades earlier. 1 28…”

Section: Discussionmentioning

confidence: 99%

“…In a systematic review with meta-analysis, we found that the relationship between childhood care and adult mortality was essentially the same across the UK, USA, Australia, and Sweden. 1 Whether this is also the case for when CVD is the outcome of interest is of course an empirical question. Fourth, the comparison group in the present analyses was represented by the general population.…”

Section: Discussionmentioning

confidence: 99%

“…The prevalence of out-of-home care, also known as state care, public care, being looked after, or substitute care, has increased in several countries in recent years with as many as 13% of children having such a history. 1 While the fundamental purpose of out-of-home care is to improve the quality of life of individuals separated from their family of origin, as adults, relative to their unexposed counterparts, this group in fact has a higher burden of negative health outcomes. A recent meta-analysis of prospective cohort studies, for instance, found that people with a history of childhood care experienced a doubling in the rate of total mortality compared with same-aged, unexposed peers, while there was tripling in the occurrence of completed suicide.…”

Section: Introductionmentioning

confidence: 99%

“…A recent meta-analysis of prospective cohort studies, for instance, found that people with a history of childhood care experienced a doubling in the rate of total mortality compared with same-aged, unexposed peers, while there was tripling in the occurrence of completed suicide. 1…”

Section: Introductionmentioning

confidence: 99%

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Cardiovascular disease in individuals with a history of out-of-home care: a Swedish national cohort study

Hjern

Brännström

Vinnerljung

et al. 2023

Preprint

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Background: Individuals with a history of out-of-home care in childhood experience elevated rates of mortality from all-causes and suicide in adulthood but the relationship with chronic disease is unknown. We examined the association between out-of-home care and cardiovascular disease (CVD) in a large cohort study and, in the women, explored how care is embodied to give rise to CVD. Methods: This is a cohort study generated from linkage of a range of Swedish national registers. Born 1972-1981, 447,516 men (12711 with a care background) and 415,910 women (11926 with a care background) were followed between care graduation at age 18 and up to age 48 years for hospitalisations and death. A subgroup of 377,500 women (87% of the birth cohort) were linked to a maternity database which yielded data on adult cigarette smoking and metabolic risk factors. Results: A maximum of 30 years of health surveillance gave rise to 5519 CVD events (2049 in women). After adjusting for the confounding factors of year of birth and maternal education, men (hazard ratio 1.95 [95% CI 1.68-2.25]) and women (1.80 [1.48-2.18]) with a history of out-of-home care in childhood had around a doubling of CVD risk in adulthood compared with general population controls. Separate presentations of CVD, such as myocardial infarction and stroke, revealed similar magnitudes of association with care. In women who had given birth, adjustment for the mediating variables of adult smoking status (1.41 [1.12-1.78]) and educational performance (1.57 [1.25-1.98]), but not metabolic risk factors (1.98 [1.24-3.15]), led to marked attenuation in CVD risk. Conclusion: In the present study, men and women separated from their family of origin in early life experienced an increased burden of CVD as adults. Results for women suggest that targeting health behaviours, teenage pregnancy, and educational performance in these groups may potentially mitigate risk. These findings add to the array of adverse adult health outcomes seemingly experienced following care graduation.

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Cardiovascular disease in individuals with a history of out-of-home care: a Swedish national cohort study

Hjern

Brännström

Vinnerljung

et al. 2023

Preprint

Self Cite

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Social Determinants of Health and Suicide-Related Outcomes

Na,

Shin,

Kwak

et al. 2025

JAMA Psychiatry

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ImportancePreventing suicide is one of the top priorities in public health policy. Identifying key social determinants of health (SDOH) in suicide risk is critical for informing clinical practices, future research, and policy solutions to prevent suicide.ObjectiveTo examine the associations of SDOH with suicide-related outcomes.Data SourcesStudies published before July 2023 were searched through PubMed, PsycINFO, Embase, and Web of Science. The date of the search was August 4, 2023.Study SelectionWe included the most up-to-date meta-analyses reporting associations between SDOH and suicide-related outcomes.Data Extraction and SynthesisThree independent reviewers extracted data and conducted quality assessment using the Joanna Briggs Institute Checklist for Systematic Reviews and Research Syntheses.Main Outcomes and MeasuresThe main outcomes of interest were suicide mortality, suicide attempt, and suicidal ideation.ResultsA total of 46 meta-analyses met inclusion criteria. For suicide mortality, justice system–involved individuals in the community, exposure to others’ and parental suicide, firearm accessibility, divorce, experience in foster care, release from incarceration, and midlife (age 35-65 years) unemployment were the SDOH with consistently strong effects. Individuals released from incarceration demonstrated a high prevalence of suicide mortality (114.5 per 100 000 persons). With regard to suicide attempt, experience of childhood abuse and maltreatment and sexual assault, gender and sexual minority status, and parental suicide mortality were the strongest risk factors. The prevalence of suicide attempt among homeless individuals (28.9%; 95% CI, 21.7%-37.2%) and incarcerated female youths (27%; 95% CI, 20%-34%) and adults (12.2%; 95% CI, 7.1%-17.2%) was high. For suicidal ideation, identification as bisexual and intimate partner violence in women were the strongest risk factors. The prevalence of lifetime suicidal ideation in homeless individuals was 41.6% (95% CI, 28.6%-56.0%). Protective factors associated with reduced risk of suicide mortality were religious affiliation and being married. School connectedness showed protective associations against suicide attempt and suicidal ideation.Conclusions and RelevanceTailoring interventions and future research for identified priority subpopulations, such as justice system–involved individuals in the community, and implementing policy measures addressing the SDOH that showed strong associations with suicide mortality, attempts, and ideation, such as gun licensing requirements, are critical to counteracting social and environmental forces that increase suicide risk.

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Koexistenz von Depression, Angst, traumatischem Stress und körperlicher Krankheit – allgemeine Positionen

Kapfhammer

2023

Depression, Angst Und Traumatischer Stress in Der Chirurgie

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State care in childhood and adult mortality: a systematic review and meta-analysis of prospective cohort studies

Cited by 21 publications

References 76 publications

Cardiovascular disease in individuals with a history of out-of-home care: a Swedish national cohort study

Cardiovascular disease in individuals with a history of out-of-home care: a Swedish national cohort study

Social Determinants of Health and Suicide-Related Outcomes

Koexistenz von Depression, Angst, traumatischem Stress und körperlicher Krankheit – allgemeine Positionen

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