| 11. |
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| 12. |
- Berlin, Marie, et al.
(författare)
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Dental health care utilization among young adults who were in societal out-of-home care as children : a Swedish national cohort study
- 2018
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Ingår i: International Journal of Social Welfare. - : John Wiley & Sons. - 1369-6866 .- 1468-2397. ; 27:4, s. 325-336
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Tidskriftsartikel (refereegranskat)abstract
- We used Swedish national registers to analyse dental health care among young adults with childhood experience of out‐of‐home care (OHC), in Cox regression analyses. All 1.7 million Swedish residents born in 1980–1994 were included, of whom 4% had been in OHC. The population was followed up in the Dental Health Register from age 20 to 29, during the period 2009–2014. We found that persons with short or long OHC experience made emergency dental care visits more often than their majority‐population peers: 17–23% versus 9–10%, (adjusted Hazard ratios [HR:s] 1.60–2.02); they more often had tooth extractions, 9–12% versus 3% (HR:s 2.33–3.03); but less regularly visited a dentist for planned check‐ups, 61–77% versus 80–87% (HR:s 0.76–0.78). Since dental health in young adulthood reflects dental health and dental care in childhood, the findings of this study call for improved preventive dental health care for children in OHC.
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| 13. |
- Berlin, Marie, et al.
(författare)
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Educational outcomes of children from long-term foster care : Does foster parents’ educational attainment matter?
- 2019
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Ingår i: Developmental Child Welfare. - : SAGE Publications. - 2516-1032 .- 2516-1040. ; 1:4, s. 344-359
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Tidskriftsartikel (refereegranskat)abstract
- Parental education is a robust predictor of children’s educational outcomes in general population studies, yet little is known about the intergenerational transmission of educational outcomes in alternative family settings such as children growing up in foster care. Using Swedish longitudinal register data on 2,167 children with experience of long-term foster care, this study explores the hypothesized mediating role of foster parents’ educational attainment on foster children’s educational outcomes, here conceptualized as having poor school performance at age 15 and only primary education at age 26. Results from gender-stratified regression analyses suggest that there was an association between foster parental educational attainment and foster children’s educational outcomes but that the educational transmission was weak and inconsistent and differed somewhat between males and females. For males, lower educational attainment in foster parents was associated with poor school performance but was not associated with educational attainment at age 26. The reverse pattern was found among females: the educational gradient was inconsistent for poor school performance but appeared in educational attainment. The results indicate that supported interventions for improving foster children’s educational achievements are needed, even when placements are relatively stable and foster parents have a long formal education.
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| 14. |
- Björkenstam, Emma, et al.
(författare)
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Adverse childhood experiences and disability pension in early midlife : results from a Swedish National Cohort Study
- 2017
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Ingår i: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 27:3, s. 472-477
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Tidskriftsartikel (refereegranskat)abstract
- Background: Few studies have examined the association between adverse childhood experiences (ACEs) and disability pension (DP). The current study aimed to investigate the relationship between different ACEs, cumulative ACEs, and DP, and the mediating role of school performance. Methods: We used a Swedish cohort of 522 880 individuals born between 1973 and 1978. ACEs included parental death, parental substance abuse and psychiatric disorder, substantial parental criminality, household public assistance, parental DP and child welfare intervention. Estimates of risk of DP in 2008 were calculated as odds ratios (OR) with 95% confidence intervals (CIs). Results: A total of 2.3% (3.0% females, 1.7% males) received DP in 2008. All studied ACEs increased the odds for DP, particularly child welfare intervention and household public assistance. Cumulative ACEs increased the odds of DP in a graded manner. Females exposed to 4+ ACEs had a 4-fold odds (OR: 4.0, 95% CI 3.5-4.5) and males a 7-fold odds (OR: 7.1, 95% CI: 6.2-8.1). School performance mediated the ACEs-DP association. Conclusion: This study provides evidence that ACEs is associated with increased odds of DP, particularly when accumulated. The effects of ACEs should be taken into account when considering the determinants of DP, and when identifying high-risk populations.
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| 15. |
- Björkenstam, Emma, et al.
(författare)
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Impact of childhood adversities on depression in early adulthood : A longitudinal cohort study of 478,141 individuals in Sweden
- 2017
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Ingår i: Journal of Affective Disorders. - : Elsevier BV. - 0165-0327 .- 1573-2517. ; 223, s. 95-100
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Although the relationship between childhood adversity (CA) and depression is widely accepted, there is little information on what proportion of depression is attributable to CA. Method: We used a Swedish cohort of 478,141 individuals born in 1984-1988 in Sweden. Register-based CA indicators included parental death, parental substance abuse and psychiatric morbidity, parental criminality, parental separation, public assistance recipiency, child welfare intervention, and residential instability. Estimates of risk of depression, measured as retrieval of prescribed antidepressants and/or psychiatric care with a clinical diagnosis of depression, between 2006 and 2012 were calculated as Hazard Ratios (HR) with 95% confidence intervals (CI), using a Cox regression analysis. Results: All CAs predicted depression in early adulthood. Furthermore, the predictive association between the CA indicators and depression was graded, with highest HRs observed for 4+ CAs (HR: 3.05 (95% CI 2.83-3.29)) for a clinical diagnosis for depression and HR: 1.32 (95% CI 1.25-1.41) for antidepressant medication after adjustments were made for important confounding factors. Of the studied CAs, child welfare intervention entailed highest HR for depression. Conclusion: Regardless of causality issues, children and youth with a history of multiple CA should be regarded as a high-risk group for depression by professionals in social, and health service's that come into contact with this group.
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| 16. |
- Brännström, Lars, et al.
(författare)
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Child welfare clients have higher risks for teenage childbirths : which are the major confounders?
- 2016
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Ingår i: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 26:4, s. 592-597
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Tidskriftsartikel (refereegranskat)abstract
- Background: Aiming to support effective social intervention strategies targeting high-risk groups for teenage motherhood, this study examined to what extent the elevated crude risks of teenage childbirth among child welfare groups were attributable to the uneven distribution of adverse individual and family background factors. Methods: Comprehensive longitudinal register data for more than 700 000 Swedish females born 1973–1989 (including around 29 000 child welfare clients) were analysed by means of binary logistic regression. The Karlson/Holm/Breen-method was used to decompose each confounding factor’s relative contribution to the difference between crude and adjusted odds ratios (ORs). Results: Elevated crude risks for teenage childbirth are to a large extent attributable to selection on observables. Girls’ school failure was the most potent confounder, accounting for 28–35% of the difference between crude and adjusted ORs. Conclusion: As in majority populations, girls’ school failure was a strong risk factor for teenage childbirth among former child welfare children. At least among pre-adolescents, promoting school performance among children in the child welfare system seems to be a viable intervention path.
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| 17. |
- Brännström, Lars, et al.
(författare)
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Childhood risk factors for disability pension among adult former Swedish child welfare clients : Same or different as for majority population peers?
- 2018
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Ingår i: Children and youth services review. - : Elsevier BV. - 0190-7409 .- 1873-7765. ; 84, s. 94-102
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Tidskriftsartikel (refereegranskat)abstract
- This study contributes to the literature on preventing social exclusion, here indicated by collecting disability pension in adulthood, by asking whether the pattern and strength of childhood related risk factors is the same for high-risk child welfare clients, as for their peers in the majority population. Longitudinal register data on > 500,000 Swedes, including around 18,000 former child welfare clients, were analyzed by means of linear probability models and calculations of population attributable fractions. Systematic comparisons of effect sizes suggest that the differences in pattern were marginal, but there were significant differences in strength. Overall, poor educational achievement and low educational attainment were the two most prominent risk factors across all groups, also when prevalence was taken into account. In the majority population, the hypothetical reduction of collecting disability pension was on the scale of 20% if either of the two risk factors could be eliminated. Among child welfare alumni, however, the hypothetical reduction was even larger, nearly 30% on average. Prevention strategies targeting poor school performance and low educational attainment may thus substantially reduce the prevalence of disability pension among adults with a history of child welfare involvement.
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| 18. |
- Brännström, Lars, 1972-, et al.
(författare)
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Children Placed In Out-of-Home Care as Midlife Adults : Are They Still Disadvantaged or Have They Caught Up With Their Peers?
- 2017
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Ingår i: Child Maltreatment. - : SAGE Publications. - 1077-5595 .- 1552-6119. ; 22:3, s. 205-214
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Tidskriftsartikel (refereegranskat)abstract
- International research has consistently reported that children placed in out-of-home care (OHC) have poor outcomes in young adulthood. Yet, little is known about their outcomes in midlife. Using prospective data from a cohort of more than 14,000 Swedes born in 1953, of which nearly 9% have been placed in OHC, this study examines whether there is developmental continuity or discontinuity of disadvantage reaching into middle age in OHC children, compared to same-aged peers. Outcome profiles, here conceptualized as combinations of adverse outcomes related to education, economic hardship, unemployment, and mental health problems, were assessed in 1992–2008 (ages 39–55). Results indicate that having had experience of OHC was associated with 2-fold elevated odds of ending up in the most disadvantaged outcome profile, controlling for observed confounding factors. These findings suggest that experience of OHC is a strong marker for disadvantaged outcomes also in midlife.
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| 19. |
- Brännström, Lars, 1972-, et al.
(författare)
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Effectiveness of Sweden's Contact Family/Person Program for older children
- 2015
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Ingår i: Research on social work practice. - : SAGE Publications. - 1049-7315 .- 1552-7581. ; 25:2, s. 190-200
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To estimate the impacts of Sweden’s Contact Family/Person Program (CFPP) for older children on participants’ long-term outcomes related to mental health problems, illicit drug use, public welfare receipt, placement in out-of-home care, educational achievement, and offending. Method: We analyzed longitudinal register data on more than 1,000,000 individuals born between 1973 and 1984, including 6,386 individuals who entered CFPP at 10–13 years of age, with a follow-up until 2008. The program impact was estimated by means of propensity score matching. Results: Outcomes for those who had received the intervention were not better than that for matched peers who did not receive the intervention. Conclusions: The results did not find support for CFPP effectiveness in reducing risks of compromised long-term development in older children.
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| 20. |
- Brännström, Lars, et al.
(författare)
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Kontaktfamilj/person för yngre och äldre barn : Har insatsens varaktighet och ansamlingar av ogynnsamma omständigheter under barnens uppväxt någon betydelse för utfall på lång sikt?
- 2015
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Rapport (populärvet., debatt m.m.)abstract
- I denna rapport undersöks om insatsens varaktighet och ansamlingar av ogynnsamma omständigheter under uppväxten har ett samband med hur det går på längre sikt för de barn där insatsen kontaktfamilj eller kontaktperson inleddes under småbarnsåren och/eller förpuberteten. Analyserna omfattar alla de barn födda i Sverige 1973-1990 där insatsen påbörjades när de var 2-5 år (n=6 693) och/eller när de var 10-13 år (n=6 389).Med hjälp av avancerade regressionsanalyser ser vi att sammansättningen av bakgrundsproblem inte verkar ha något tydligt specifikt samband med hur det går i framtiden. Det är antalet problem som verkar betyda något. I den yngre gruppen verkar barnen med flest problemfaktorer i hembakgrunden ha dragit nytta av längre insatstid. Där är det med andra ord möjligt att en långvarig tillgång till en kompenserande vuxenmiljö utanför den egna familjen kan ha påverkat de mest utsatta barnens utveckling på sikt. För barn med färre problemfaktorer fanns det ingen sådant samband, snarare tendenser till det omvända. Det verkar med andra ord som om en långvarig insats för de yngre barnen fungerar bättre för de ’svåraste fallen’.För de äldre barnen ser vi svaga tendenser till ett motsatt mönster. De med lägst antal problemfaktorer är de som verkar ha fått svag nytta av lång insatstid. Här är det viktigt att vara medveten om att vi bara har tillgång data som tyder problem i hemmet, inte hos barnet själv (t.ex. förekomsten av beteendeproblem). Det verkar med andra ord som om insatsen var för svag för de mest utsatta barnen. Den äldre gruppen hade generellt mer tecken på problem i barndomen (t.ex. höga förekomster av psykisk ohälsa hos föräldrarna) än den yngre gruppen barn. Den äldre gruppen barn verkar också ha klarat sig betydligt sämre i tonåren och i ung vuxen ålder.Eftersom våra sambandsanalyser inte har någon jämförelsegrupp av barn som inte fått någon insats (alla som ingår i analysen har fått mer eller mindre av insatsen) är det viktigt att påpeka att vi med det här sättet att analysera inte kan säga något om insatsen är effektiv eller inte. De mönster vi alltjämt har funnit ska därför tolkas som ’tendenser till dämpad försämring’ över tid. Det finns dock ingenting som tyder på att socialtjänsten bör vara restriktiv med att ge yngre barn från utsatta familjer en kontaktfamiljsinsats under lång tid. För de äldre barnen finns det dessvärre inga resultat som är tillräckligt handfasta för att tjäna som underlag för rekommendationer.
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