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- Almquist, Ylva B., et al.
(author)
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A decade lost : does educational success mitigate the increased risks of premature death among children with experience of out-of-home care?
- 2018
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In: Journal of Epidemiology and Community Health. - : BMJ. - 0143-005X .- 1470-2738. ; 72:11, s. 997-1002
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Journal article (peer-reviewed)abstract
- Background: Past research has consistently identified children with experience of out-of-home care (OHC) as a high-risk group for premature mortality. While many have argued that educational success is a key factor in reducing these individuals’ excessive death risks, the empirical evidence has hitherto been limited. The aim of the current study was therefore to examine the potentially mitigating role of educational success for the association between OHC experience and premature mortality.Methods: Drawing on a Stockholm cohort born in 1953 (n=15,117), we analysed the associations between placement in OHC (ages 0-12), school performance (ages 13, 16, and 19), and premature all-cause mortality (ages 20-56) by means of Cox and Laplace regression analysis.Results: The Cox regression models confirmed the increased risk of premature mortality among individuals with OHC experience. Unadjusted Laplace regression models showed that these children died more than a decade, based on median survival time, before their majority population peers. However, among individuals who performed well at school, i.e. scored above-average marks at age 16 (grade 9) and age 19 (grade 12), respectively, the risks of premature mortality did not significantly differ between the two groups.Conclusion: Educational success seems to mitigate the increased risks of premature death among children with experience of OHC.
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3. |
- Berlin, Marie, et al.
(author)
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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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In: International Journal of Social Welfare. - : John Wiley & Sons. - 1369-6866 .- 1468-2397. ; 27:4, s. 325-336
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Journal article (peer-reviewed)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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4. |
- Brännström, Lars, et al.
(author)
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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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In: Children and youth services review. - : Elsevier BV. - 0190-7409 .- 1873-7765. ; 84, s. 94-102
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Journal article (peer-reviewed)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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5. |
- Hjern, Anders, et al.
(author)
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Gender aspects of health-related quality of life of youth in secure residential care in Sweden
- 2018
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In: International Journal of Social Welfare. - : Wiley. - 1369-6866 .- 1468-2397. ; 27:4, s. 358-363
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Journal article (peer-reviewed)abstract
- This study examined health-related quality of life of youth in secure residential care employing a gender perspective. The KIDSCREEN-52 questionnaire was administered to 91 youths (46 boys and 45 girls) aged 13-17, admitted to four secure residential units in southern Sweden, in connection with a medical examination. Results were compared with a national Swedish survey from 2009 of 86,000 youths aged 15-16years old. In age-adjusted analyses, youth in secure residential care units reported lower levels of wellbeing for all but one KIDSCREEN measure, compared with the national survey, with moderate to large differences in effect size. In the residential care sample, female gender was associated will lower psychological wellbeing, poorer parental relations and less school satisfaction, while male gender was associated with lower self-perception and peer relations.
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6. |
- Liu, Can, et al.
(author)
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Out-of-Home Care and Subsequent Preterm Delivery : An Intergenerational Cohort Study
- 2018
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In: Pediatrics. - : American Academy of Pediatrics (AAP). - 0031-4005 .- 1098-4275. ; 142:2
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Journal article (peer-reviewed)abstract
- OBJECTIVES: Adverse early-life experience may affect preterm delivery later in life through priming of stress response. We aim to investigate the links between out-of-home care (OHC) experience in childhood, as a proxy of severe adversities, on subsequent risk of preterm delivery. METHODS: A register-based national cohort of all women born in Sweden between 1973 and 1977 (N = 175 821) was crosslinked with information on these women's subsequent deliveries as recorded in the Swedish medical birth register. During 1986-2012, 343 828 livebirths of these women were identified. The associations between women's OHC experience and her risk of preterm delivery were analyzed through logistic regression models, adjusting for women's own preterm birth, intrauterine growth, and childhood socioeconomic situation. RESULTS: Compared with women that never entered OHC, women with OHC experience up to and after age 10 were both associated with increased risks of preterm delivery (adjusted odds ratio [aOR] = 1.23 [95% confidence interval 1.08-1.40] and aOR = 1.29 [1.13-1.48], respectively). Women who experienced OHC before or at 10 years of age had increased risk of both spontaneous and medically indicated preterm delivery (aOR = 1.19 [1.03-1.38] and aOR = 1.27 [1.02-1.59], respectively). Women who experienced OHC after age 10 had a more pronounced risk of medically indicated preterm delivery (aOR = 1.76 [1.44-2.16]) than for spontaneous preterm delivery (aOR = 1.08 [0.92-1.27]). CONCLUSIONS: Women who were placed in OHC in childhood had increased risk of preterm delivery independent from their own perinatal history. Stress response, as 1 consequence of early life adversities, may take its toll on women's reproductive health and their offspring, calling for integrative efforts in preventing early life adversity.
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7. |
- Vinnerljung, Bo, et al.
(author)
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Health problems and healthcare needs among youth in Swedish secure residential care
- 2018
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In: International Journal of Social Welfare. - : Wiley. - 1369-6866 .- 1468-2397. ; 27:4, s. 348-357
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Journal article (peer-reviewed)abstract
- International research has consistently reported that youth in secure residential care have high rates of somatic/dental health problems. Here, we report results from the first such study in a Nordic country. An experienced paediatrician performed systematic somatic and rudimentary dental health assessments of 91 youths, age 13-17, recently admitted to four secure residential units in Sweden. Girls were oversampled. Participants were tested for sexually transmitted diseases (STD). We found large unmet needs of health/dental care, similar to reports from other countries: 75% of the girls and 53% of the boys had at least one previously known health problem that was poorly followed up or was unknown before the assessment. Over 40% of the girls had severe dental decay. Only two cases of STD were identified (Chlamydia). Some 91% of the girls and 64% of the boys were referred to a health or a dental care clinic.
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8. |
- Wall-Wieler, Elizabeth, et al.
(author)
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Avoidable mortality among parents whose children were placed in care in Sweden : a population-based study
- 2018
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In: Journal of Epidemiology and Community Health. - : BMJ. - 0143-005X .- 1470-2738. ; 72:12, s. 1091-1098
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Journal article (peer-reviewed)abstract
- BACKGROUND: Separation from one's child can have significant consequences for parental health and well-being. We aimed to investigate whether parents whose children were placed in care had higher rates of avoidable mortality.METHODS: Data were obtained from the Swedish national registers. Mortality rates among parents whose children were placed in care between 1990 and 2012 (17 503 mothers, 18 298 fathers) were compared with a 1:5 matched cohort of parents whose children were not placed. We computed rate differences and HRs of all-cause and avoidable mortality.RESULTS: Among mothers, deaths due to preventable causes were 3.09 times greater (95% CI 2.24 to 4.26) and deaths due to amenable causes were 3.04 times greater (95% CI 2.03 to 4.57) for those whose children were placed in care. Among fathers, death due to preventable causes were 1.64 times greater (95% CI 1.32 to 2.02) and deaths due to amenable causes were 1.84 times greater (95% CI 1.33 to 2.55) for those whose children were placed in care. Avoidable mortality rates were higher among mothers whose children were young when placed in care and among parents whose children were all placed in care.CONCLUSIONS: Parents who had a child placed in out-of-home care are at higher risk of avoidable mortality. Interventions targeting mothers who had a child aged less than 13 placed in care, and parents whose children were all placed in care could have the greatest impact in reducing avoidable mortality in this population.
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9. |
- Wall-Wieler, Elizabeth, et al.
(author)
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Intergenerational transmission of out-of-home care in Sweden : A population-based cohort study
- 2018
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In: International Journal of Child Abuse & Neglect. - : Elsevier BV. - 0145-2134 .- 1873-7757. ; 83, s. 42-51
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Journal article (peer-reviewed)abstract
- The objective of this study is to examine the intergenerational transmission of out-of-home care. This population-based study used data from the Swedish National Registers and included all children born in Sweden between 1990 and 2012 (followed for up to 13 years), whose parents were both born in Sweden between 1973 and 1980 (278 327 children; 145 935 mothers; 146 896 fathers). Cox regression models are used to obtain crude and adjusted hazard ratios (HR) of OHC placement among children based on parents’ history of OHC. Compared with children whose parents both did not have a history of OHC, the risk of being placed in OHC was greater when both parents spent time in OHC (crude HR = 48.70, 95% CI 41.46–57.21; adjusted HR = 3.04, 95% CI = 2.54–3.64), however, children who had only one parent who spent time in care were also at higher risk (mothers only adjusted HR = 2.37, 95% CI = 2.08–2.70; fathers only adjusted HR = 1.33, 95% CI = 1.13–1.55). The crude rate of placement in OHC was highest for children whose parents were placed in care during adolescence, but after adjusting for social and behavioral covariates, children whose parents were in care in early childhood were at greater risk of OHC than children whose parents were in care in adolescence. To reduce this intergenerational transmission of OHC, more supports should be provided to parents who spent time in OHC to ensure a successful transition to parenthood.
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