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- Almquist, Ylva B., et al.
(author)
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Association of Child Placement in Out-of-Home Care With Trajectories of Hospitalization Because of Suicide Attempts From Early to Late Adulthood
- 2020
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In: JAMA Network Open. - : American Medical Association (AMA). - 2574-3805. ; 3:6
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Journal article (peer-reviewed)abstract
- Importance Children placed in out-of-home care (OHC) have higher rates of suicidal behaviors, including suicide attempts, compared with those who grow up in their family of origin. Several studies have shown that this elevated risk persists into young adulthood. Yet, our knowledge about any longer-term associations of OHC with suicide attempts is limited. Objective To examine how childhood experiences of placement in OHC are associated with trajectories of hospitalization because of suicide attempts (HSA) from early into late adulthood. Design, Setting, and Participants This prospective birth cohort study that was conducted in Stockholm, Sweden, and analyzed in March 2020 included 14559 individuals born in 1953 who were living in the greater metropolitan of Stockholm in November 1963 and followed through registers up until December 2016. Exposures Childhood experiences of OHC based on information from the Social Register (age 0-19 years). Main Outcomes and Measures Hospitalization because of suicide attempts based on in-patient care data from the National Patient Register. Group-based trajectory modeling was used to cluster individuals according to their probabilities of HSA across adulthood (age 20-63 years). Results In this cohort of 14559 individuals (7146 women [49.1%]), 1320 individuals (9.1%) had childhood experiences of OHC, whereas 525 individuals ( 3.6%) had HSA. A Cox regression analysis showed a substantially higher risk of HSA among those with childhood experiences of OHC (hazard ratio, 3.58; 95% CI, 2.93-4.36) and after adjusting for a range of adverse childhood living conditions (hazard ratio, 2.51; 95% CI, 2.00-3.15). Those with at least 1 HSA were grouped into 4 trajectories: (1) peak in middle adulthood (66 [12.6%]), (2) stable low across adulthood (167 [31.8%]), (3) peak in early adulthood (210 [40.0%]), and (4) peak in emerging adulthood (82 [15.6%]). A multinomial regression analysis suggested that those with experiences of OHC had higher risks of following any of these trajectories (trajectory 1: relative risk ratio [RRR], 2.91; 95% CI, 1.61-5.26; trajectory 2: RRR, 3.18; 95% CI, 2.21-4.59; trajectory 3: RRR, 4.32; 95% CI, 3.18-5.86; trajectory 4: RRR, 3.26; 95% CI, 1.94-5.46). The estimates were reduced after adjusting for adverse childhood living conditions. Conclusions and Relevance The findings suggest that the elevated risk of suicide attempts among former child welfare clients does not cease after young adulthood, indicating the necessity for clinical attention to childhood experiences of OHC as a risk marker for suicidal behavior across the life span. Question How are childhood experiences of placement in out-of-home care associated with trajectories of hospitalization because of suicide attempts from early into late adulthood? Findings In this cohort study of 14559 individuals, individuals were grouped into 4 trajectories with differential onset of suicide attempts across adulthood. Childhood experiences of placement in out-of-home care were associated with increased risks of following each of these trajectories. Meaning The elevated risk of suicide attempts among former child welfare clients persists into young adulthood, indicating the necessity for clinical attention to childhood experiences of out-of-home care as a risk marker for suicidal behavior across the life span. This cohort study examines the association between childhood experiences of placement in out-of-home care and trajectories of hospitalization because of suicide attempts from early into late adulthood in Sweden.
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2. |
- Brännström, Lars, 1972-, et al.
(author)
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Rethinking the Long-term Consequences of Growing up in a Disadvantaged Neighbourhood : Lessons from Sweden
- 2012
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In: Housing Studies. - : Informa UK Limited. - 0267-3037 .- 1466-1810. ; 27:6, s. 729-747
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Journal article (peer-reviewed)abstract
- Using extensive longitudinal register data for more than 80 000 young metropolitan Swedes, this study addresses the effect of a disadvantaged neighbourhood social context on groupings of outcomes that are important for the living conditions of young adults. The overall results show that growing up in a disadvantaged neighbourhood increases the risk of experiencing comparably more unemployment, having less education and receiving more social assistance than similar young people from more affluent neighbourhoods. However, when the estimated effects of neighbourhood are assessed by means of an epidemiological impact measure that takes the prevalence of the risk factor at population level into account; these effects prove to be minimal. We discuss possible drawbacks of placing too much emphasis on policies targeting disadvantaged neighbourhoods versus universal social policy measures.
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- Mäkinen, Ilkka Henrik, 1956-, et al.
(author)
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Labour Market, Work Environment, and Suicide
- 2021. - 2
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In: Oxford Textbook of Suicidology and Suicide Prevention. - Oxford : Oxford University Press. - 9780198834441 - 9780191873805 ; , s. 249-258
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Book chapter (other academic/artistic)abstract
- Work is an important sphere of human life. Besides economic subsistence, it also furnishes workers with social status and influences their life conditions. Social class seems to be connected with suicidality, but studies on the effects of specific occupations have produced few lasting results. In addition, lack of adequate data and problems with the methods cause problems in the estimates of suicide mortality by class or occupation. However, it seems that the most vulnerable position is that of those who do not work at all. There is abundant empirical evidence of a surplus risk for suicide among the unemployed, but the causal nature of this relationship still needs clarification. Globally, the labour markets differ greatly, and so does their connection with suicide. Labour-market-oriented suicide prevention issues concern unemployment policies, reduction of work-related access to means of suicide, and the use of the workplace as a base for suicide prevention.
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6. |
- Mäkinen, Ilkka Henrik, 1956-, et al.
(author)
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Social Theories of Suicide
- 2021. - 2
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In: Oxford Textbook of Suicidology and Suicide Prevention. - Oxford : Oxford University Press. - 9780198834441 - 9780191873805 ; , s. 137-146
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Book chapter (peer-reviewed)abstract
- In this chapter, some social theories in relation to suicide are presented together with examples from actual research. Although an individual act, suicide can be studied as a collective phenomenon, for example, as the relative number of cases that occur in different groups. Most social-scientific theories of suicide consider these not only as accumulations of individual observations, but also as results of social-level properties, events, and processes. The social environment in its different forms is thought to be connected with suicidal behaviour in multiple ways—the reasons for, the performance of, and the communication about the act all have strong social components. The currents in social research into suicide coincide largely with those in the social sciences more generally, with a preponderance, however, of structuralist studies following in the footsteps of Emile Durkheim.
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7. |
- Rojas, Yerko, 1978-
(author)
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Childhood Social Exclusion and Suicidal Behavior in Adolescence and Young Adulthood
- 2014
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Doctoral thesis (other academic/artistic)abstract
- In this thesis I analyze, with the help of social epidemiological theories, childhood risk factors behind suicidal behavior in adolescence and young adulthood. The data comes mainly from the Swedish “Stockholm Birth Cohort Study” (SBC) consisting of 15,117 participants. A total of four separate studies are included.The first study is restricted to boys born in 1953. By analyzing data from different registers and questions from a survey conducted when they were 12-13 years old it is shown that those who spent most of their time alone, had been absent from school even though they were not ill or grew up in a family which received means-tested benefits at least once during their childhood had a higher risk of taking their own lives. The second study includes the same boys, but suicidal behavior is extended to also encompass suicide attempts and is analyzed in parallel with interpersonal violence. The results show that these different behaviors can be similarly explained by shortcomings in social bonds and relative deprivation during childhood. The third study, which focuses on women’s suicidality within the SBC, shows that girls with both above and below average marks in the sixth grade had a higher risk of engaging in suicidal behavior as adolescents or young adults. However, this relation only held for girls who had grown up with supportive parental ambitions in terms of educational commitment. For boys, only low school performance was shown to be suicidogenic, irrespective of parental ambitions. The fourth and final study is based on the international “Health Behavior in School-aged Children” study and information from international databases. Here it is shown that the suicide rate among 15-24 year old women in 30 European and North American countries at the end of the 2000s was inversely related to how many days a week 15 year old girls involved themselves with friends in 2005/2006.The introductory chapter of the thesis begins with a short background to the theme of social exclusion and suicidality. This section is followed by a more detailed discussion of how the notion of social recognition that is found within the social exclusion literature, can help nuance our understanding of social isolation and suicidal behavior further.
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8. |
- Rojas, Yerko
(author)
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Debt Problem of One Partner and Depressive Morbidity in the Other : A 2-Year Follow-up Register Study of Different-Sex Couples in Sweden
- 2023
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In: Journal of Family and Economic Issues. - : Springer Nature. - 1058-0476 .- 1573-3475. ; 44, s. 1-15
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Journal article (peer-reviewed)abstract
- This study sets out to examine whether depressive morbidity varies by status of financial indebtedness of a spouse or cohabiting partner. For this purpose, individuals aged between 20 and 60 with a different-sex spouse/cohabiting partner with a registration date for a debt at the Swedish Enforcement Authority (SEA) during 2017 (n = 6979) are followed-up for a 2-year period for prescriptions of antidepressants and compared with a sample from the general Swedish population (n = 29,708). The analysis is based on penalized maximum likelihood logistic regressions. Both women and men were more likely to suffer from depressive morbidity if the spouse/cohabiting partner had been registered at the SEA in 2017 and was still active for a debt in the SEA’s register in 2018 (OR 1.31 and OR 1.57, respectively), irrespective of their own health, employment, socioeconomic status, and other background variables. This also held true for men if a wife/cohabiting partner had been registered at the SEA in 2017 but was no longer active for a debt in the SEA’s register in 2018 (OR 1.29). For women, on the other hand, only those with no history (11-year period) of prescription of psychotropic medications were also at an enhanced risk of depressive morbidity if a husband/cohabiting partner had gone from being registered for a debt at the SEA in 2017, to not being registered as active for a debt in the SEA’s register in 2018 (OR 1.24). The results reinforce the importance of acknowledging that negative effects of financial indebtedness extend beyond the individual debtor.
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- Rojas, Yerko, 1978-, et al.
(author)
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Early life circumstances and male suicide : A 30-year follow-up of a Stockholm cohort born in 1953
- 2010
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In: Social Science and Medicine. - : Elsevier BV. - 0277-9536 .- 1873-5347. ; 70:3, s. 420-427
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Journal article (peer-reviewed)abstract
- This study analyses the relationship between early life circumstances and suicide during adolescence and young adulthood among men in a Stockholm birth cohort born in 1953. Relevant variables were derived from Durkheim's proposition of social integration and suicide and Merton's strain theory of deviance. The links between our background variables and suicide were estimated with rare events logistic regression, a statistical method specially developed for situations in which rare events are endemic to the data. We found that self-rated loneliness at age 12–13 as an indicator of social isolation, school absenteeism at the same age as an indicator of school integration, and growing up in a family which received means-tested social assistance at least once during the period 1953–1965 as an indicator of childhood poverty, were statistically related to subsequent suicide risk between 1970 and 1984. Furthermore, following Bourdieu's rereading of Durkheim's Suicide, we argue that social isolation and school integration can be seen as important forms of deprivation, since “social integration” can also be understood in terms of “social recognition”. This view emphasises the importance of taking the emotional and social poverty of children just as seriously as their material poverty when it comes to suicide.
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10. |
- Rojas, Yerko
(author)
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Evictions and short-term all-cause mortality : a 3-year follow-up study of a middle-aged Swedish population
- 2017
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In: International Journal of Public Health. - : Springer Science and Business Media LLC. - 1661-8556 .- 1661-8564. ; 62:3, s. 343-351
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Journal article (peer-reviewed)abstract
- ObjectivesThis study sets out to explore whether being forcibly removed from one’s home is related to all-cause mortality.MethodsWith the help of unique register data covering all middle-aged persons registered at the Swedish Enforcement Authority with a case closed by an eviction during the period 2009–2011 (n = 2092), evictees’ deaths from any cause that occurred within 3 years of the date of the eviction are compared with the all-cause mortality of a random sample of the Swedish population (n = 426,117). The analysis is based on penalized maximum likelihood logistic regressions.ResultsThose who had been evicted from their homes were found to be approximately one and a half times more likely to die from any cause than those who had not been exposed to this experience (OR = 1.59), controlling for several demographic, socio-economic and health conditions prior to the date of the eviction.ConclusionsThe results provide support for the notion that the experience of losing one’s dwelling place should be treated as a major life event in its own right, just like other well-established social stressors.
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