1. |
- Almquist B., Ylva, et al.
(author)
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Associations between social support and depressive symptoms : social causation or social selection-or both?
- 2017
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In: European Journal of Public Health. - : Oxford University Press. - 1101-1262 .- 1464-360X. ; 27:1, s. 84-89
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Journal article (peer-reviewed)abstract
- BACKGROUND: Numerous studies have demonstrated an association between social support and health, almost regardless of how social support and health have been conceptualised or measured. Even so, the issue of causality has not yet been sufficiently addressed. This issue is particularly challenging for mental health problems such as depressive symptoms. The aim of the present study is to longitudinally assess structural and functional aspects of social support in relation to depressive symptoms in men and women, through a series of competing causal models that, in contrast to many other statistical methods, allow for bi-directional effects.METHODS: Questionnaire data from the Northern Swedish Cohort (n = 1001) were utilised for the years 1995 (age 30) and 2007 (age 42). Associations were analysed by means of gender-specific structural equation modelling, with structural and functional support modelled separately.RESULTS: Both structural and functional support were associated with depressive symptoms at ages 30 and 42, for men and women alike. A higher level of support, particularly functional support, was associated with a decrease in depressive symptoms over time among men. Among women, there were bi-directional effects of social support and depressive symptoms over time.CONCLUSION: Concerning social support and health, the social causation hypothesis seems relevant for men whereas, for women, the associations appear to be more complex. We conclude that preventive and health promoting work may need to consider that the presence of depressive symptoms in itself impedes on women's capability to increase their levels of social support.
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2. |
- 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. |
- 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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4. |
- Almquist, Ylva B., et al.
(author)
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Childhood Adversity and Trajectories of Disadvantage Through Adulthood : Findings from the Stockholm Birth Cohort Study
- 2018
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In: Social Indicators Research. - : Springer Science and Business Media LLC. - 0303-8300 .- 1573-0921. ; 136:1, s. 225-245
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Journal article (peer-reviewed)abstract
- Children whose parents experience adverse social, economic, or health-related living conditions are more likely to face similar types of disadvantage in their adult life. However, a limitation of many earlier studies is that they do not account for the multidimensionality of the concept of living conditions, and that the child generation’s life courses are targeted as static and independent from the societal context in which they are imbedded. The current investigation addressed these aspects by focusing on the complexity, duration, and timing of disadvantage with regard to how adverse circumstances in the family of origin are associated with trajectories of social, economic, and health-related living conditions across adulthood. We also examined the role of educational attainment for these associations. Analyses were based a Swedish cohort born in 1953 (n = 14,294). We first conducted sequence analysis, followed by hierarchical cluster analysis, to generate ‘outcome profiles’, i.e. trajectories of adult disadvantage. Second, several indicators of adverse circumstances in childhood were analysed by means of multinominal regression analysis, showing the odds of ending up in the different trajectories. The results indicated that individuals who grew up under adverse conditions were more likely to experience disadvantaged social, economic, and health-related trajectories. This was particularly the case for trajectories characterised by a high degree of complexity, i.e. coexisting disadvantages, and—among men only—by a longer duration of disadvantage. Educational attainment was identified as a powerful mediator, suggesting that efforts to increase equal educational opportunity may be a way of reducing the intergenerational transmission of disadvantage.
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5. |
- Almquist, Ylva B., et al.
(author)
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Childhood friendships and the clustering of adverse circumstances in adulthood - a longitudinal study of a Stockholm cohort
- 2013
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In: Longitudinal and Life Course Studies. - : Bristol University Press. - 1757-9597. ; 4:3, s. 180-195
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Journal article (peer-reviewed)abstract
- Friendships constitute a central feature of childhood, yet little is known about the developmental significance extending beyond childhood and adolescence. The aim of the present study was therefore to investigate the association between childhood friendships and adult outcomes. Since many outcomes in adulthood go hand in hand, the outcome pattern as a whole was targeted. Based on a longitudinal data material consisting of more than 14,000 individuals born in Stockholm in 1953, a cluster analysis of adult circumstances (1992-2007) was first conducted. Second, the association between three indicators of childhood friendships (1966) and the outcome profiles was analysed by means of multinomial regression analysis. The results indicated that children who lacked leisure time friends and a best friend in the school class had increased risks of ending up in the more adverse clusters as adults, whereas the opposite association was found for those who reported being solitary. The effect of childhood friendships was rather consistent across both single and multiple problems, suggesting that the disadvantages of being without friends in childhood do not accumulate over the life course to any large extent. Generally, the results were the same for males and females. It is concluded that childhood friendships are important for adverse circumstances in adulthood, for both genders. As far as the long-lasting effects of children's friendships involve varying access to social support, school-based interventions should compensate for the scarcity of support following the lack of childhood friends.
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6. |
- Almquist, Ylva B.
(author)
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Childhood origins and adult destinations : The impact of childhood living conditions on coexisting disadvantages in adulthood
- 2016
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In: International Journal of Social Welfare. - : Wiley. - 1369-6866 .- 1468-2397. ; 25:2, s. 176-186
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Journal article (peer-reviewed)abstract
- The aim of this study was to analyse linkages between childhood living conditions and coexisting disadvantages in adulthood. Analyses were based on the Stockholm Birth Cohort, consisting of more than 14,000 individuals born in 1953, followed up until 2007. Based on education, labour market outcomes, economic poverty and health, four outcome profiles with varying levels of disadvantage were identified by means of latent class analysis. Coexisting disadvantages were present in approximately one-fifth of the individuals. Low educational attainment, social welfare recipiency and mental health problems simultaneously occurred in two of the profiles, suggesting that these dimensions are highly interconnected. Results from multinomial regression analysis showed that individuals who had experienced disadvantaged childhood conditions had particularly high risks of ending up in these two outcome profiles, with or without the presence of unemployment.
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7. |
- Almquist, Ylva B., et al.
(author)
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Childhood Peer Status and the Clustering of Adverse Living Conditions in Adulthood
- 2012
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Reports (other academic/artistic)abstract
- Within the context of the school class, children attain a social position in the peer hierarchy to which varying amounts of status are attached. Several studies have shown that children’s peer status is associated with a wide range of social and health-related outcomes. These studies commonly target separate outcomes, paying little attention to the fact that such circumstances are likely to go hand in hand. The overarching aim of the present study was therefore to examine the impact of childhood peer status on the clustering of living conditions in adulthood. Based on a 1953 cohort born in Stockholm, Sweden, multinomial regression analysis demonstrated that children who had lower peer status also had exceedingly high risks of ending up in more problem-burdened clusters as adults. Moreover, these associations remained after adjusting for a variety of family-related circumstances. We conclude that peer status constitutes a central aspect of children’s upbringing with important consequences for subsequent life chances, over and above the influences originating from the family.
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8. |
- Almquist, Ylva B., et al.
(author)
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Childhood Peer Status and the Clustering of Social, Economic, and Health-related Circumstances in Adulthood
- 2014
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In: Social Science and Medicine. - : Elsevier BV. - 0277-9536 .- 1873-5347. ; 105, s. 67-75
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Journal article (peer-reviewed)abstract
- Within the school-class context, children attain a social position in the peer hierarchy to which varying amounts of status are attached. Studies have shown that peer status – i.e. the degree of acceptance and likeability among classmates – is associated with adult health. However, these studies have generally paid little attention to the fact that health problems are likely to coincide with other adverse circumstances within the individual. The overarching aim of the current study was therefore to examine the impact of childhood peer status on the clustering of social, economic, and health-related circumstances in adulthood. Using a 1953 cohort born in Stockholm, Sweden (n = 14,294), four outcome profiles in adulthood were identified by means of latent class analysis: ‘Average’, ‘Low education’, ‘Unemployment’, and ‘Social assistance recipiency and mental health problems’. Multinomial regression analysis demonstrated that those with lower peer status had exceedingly higher risks of later ending up in the more adverse clusters. This association remained after adjusting for a variety of family-related and individual factors. We conclude that peer status constitutes a central aspect of children's upbringing with important consequences for life chances.
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9. |
- Almquist, Ylva B., 1983-, et al.
(author)
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Do trajectories of economic, work- and health-related disadvantages explain child welfare clients’ increased mortality risk? A prospective cohort study
- 2019
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In: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 19
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Journal article (peer-reviewed)abstract
- BackgroundPast research has shown that individuals who have had experiences of out-of-home care (OHC) in childhood have increased risks of premature mortality. Prior studies also suggest that these individuals are more likely to follow long-term trajectories that are characterised by economic, work-, and health-related disadvantages, compared to majority population peers. Yet, we do not know the extent to which such trajectories may explain their elevated mortality risks. The aim of this study is therefore to examine whether trajectories of economic, work-, and health-related disadvantages in midlife mediate the association between OHC experience in childhood and subsequent all-cause mortality.MethodsUtilising longitudinal Swedish data from a 1953 cohort (n = 14,294), followed from birth up until 2008 (age 55), this study applies gender-specific logistic regression analysis to analyse the association between OHC experience in childhood (ages 0–19; 1953–1972) and all-cause mortality (ages 47–55; 2000–2008). A decomposition method developed for non-linear regression models is used to estimate mediation by trajectories of economic, work-, and health-related disadvantages (ages 39–46; 1992–1999), as indicated by social welfare receipt, unemployment, and mental health problems. To account for selection processes underlying placement in OHC, an alternative comparison group of children who were investigated by the child welfare committee but not placed, is included.ResultsThe results confirm that individuals with experience of OHC have more than a two-fold increased risk of all-cause mortality, for men (OR: 2.10, 95% CI: 1.42–3.11) and women (OR: 2.23, 95% CI: 1.39–3.59) alike. Approximately one-third (31.1%) of the association among men, and one-fourth (27.4%) of the association among women, is mediated by the long-term trajectories of economic, work-, and health-related disadvantages. The group who were investigated but not placed shows similar, yet overall weaker, associations.ConclusionsIndividuals who come to the attention of the child welfare services, regardless of whether they are placed in out-of-home care or not, continue to be at risk of adverse outcomes across the life course. Preventing them from following trajectories of economic, work-, and health-related disadvantages could potentially reduce their risk of premature death.
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10. |
- Almquist, Ylva B., et al.
(author)
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Friendship network characteristics and psychological well-being in late adolescence : Exploring differences by gender and gender composition
- 2014
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In: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 42:2, s. 146-154
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Journal article (peer-reviewed)abstract
- Aims: The aim of the present study was to examine the association between friendship networks and psychological well-being among 19-year-olds. Methods: The data used was a random sample of Swedish individuals born in 1990 who answered a questionnaire in 2009-2010. Friendship networks were considered in terms of three measures of emotional support. Six statements about the individual's emotional state were used to create a summary measure of psychological well-being. Gender and gender composition were included as potentially moderating factors. The association between friendship networks and psychological well-being was analysed by means of linear regression analysis (n = 1289). Results: The results indicate that males' and females' friendship networks were similar with regard to quality and trust, whereas males' networks were characterized by less self-disclosure and a stronger preference for same-gender friendships. Gender composition did not matter for the support levels. Emotional support was associated with psychological well-being but there were gender differences: females seemed to benefit more health-wise from having high-quality (and trusting) networks. Moreover, whereas self-disclosure among males was positively linked to well-being, this was not the case among females. None of these associations were moderated by gender composition. Conclusions: In sum, friendship networks are beneficial for the psychological well-being among late adolescents, but there are some important differences according to gender.
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11. |
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12. |
- Almquist, Ylva B, et al.
(author)
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Growing through asphalt : What counteracts the long-term negative health impact of youth adversity?
- 2017
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In: European Journal of Public Health. - : Oxford University Press. - 1101-1262 .- 1464-360X. ; 27:Suppl 3, s. 47-47
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Journal article (other academic/artistic)abstract
- Background: Adversity in the family of origin tends to translate into poor health development. Yet, the fact that this is not the always the case has been seen an indicator of resilience. The current study highlights factors outside the context of the family with the potential to counteract the long-term negative influences of social and material adversity in adolescence on general health status.Methods: The study was based on the Northern Swedish Cohort born in 1965 (n = 1,001). Measures of social and material adversity, health, and protective factors related to school, peers, and spare time, were derived from questionnaires distributed to the cohort members and their teachers at age 16. Self-rated health was measured at age 43. The main associations were examined by means of ordinal regression analysis, with the role of the protective factors being assessed through interaction analysis.Results: Social and material adversity in youth was associated with poorer self-rated health in midlife among males and females alike, net of health status at baseline. However, having an advantaged situation with regard to school, peers, or spare time – particularly in terms of being seen as having good educational and work prospects, as well as a high-quality spare time – appeared to protect against the detrimental influences of disadvantaged circumstances in the family context on subsequent health.Conclusions: There are several factors outside the context of the family that seemingly have the potential to buffer against the negative health consequences stemming from having experienced a disadvantaged upbringing. Initiatives targeted at increasing academic motivation and commitment as well as social capital and relationships in youth, may here be of particular relevance.Key messages:While the experience of disadvantageous living conditions in adolescence tends to translate into poor health development across the life course, this is not always the case.Advantages related to school, peers, and spare time have the potential of counteracting the negative health impact of an adverse family context.
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13. |
- Almquist, Ylva B., et al.
(author)
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Hälsosamt samspel i skolan
- 2012
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In: Framtider. - 0281-0492. ; :3, s. 12-15
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Journal article (other academic/artistic)
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14. |
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15. |
- Almquist, Ylva B, 1983-, et al.
(author)
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Is there a peer status gradient in mortality? Findings from a Swedish cohort born in 1953 and followed to age 67
- 2023
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In: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 33:2, s. 184-189
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Journal article (peer-reviewed)abstract
- Background Similar to having a less advantaged socioeconomic position, children in lower peer status positions typically experience a situation characterized by less power, influence and command over resources, followed by worse health outcomes. The aim of this study was to examine whether peer status position is further associated with increased risks for premature all-cause mortality. Methods Data were drawn from a 1953 cohort born in Stockholm, Sweden. Peer status positions were established through survey data on peer nominations within the school class at age 13, whereas national registers were used to identify all-cause mortality across ages 14-67. Differences in hazard rates and median survival time, according to peer status position, were estimated with Cox regression and Laplace regression, respectively. Results Although differences in hazard rates were not large, they were consistent and clear, also after taking childhood socioeconomic status into account. Regarding median survival time, the number of years lost increased gradually as peer status decreased, with a difference of almost 6 years when comparing individuals in the lowest and highest positions. Conclusions Children's positions in the peer status hierarchy play a role for their chances of health and survival, pointing to the relevance of addressing opportunities for positive peer interaction and mitigating any adverse consequences that may stem from negative experiences within the peer context.
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16. |
- Almquist, Ylva B., et al.
(author)
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Only the lonely? All-cause mortality among children without siblings and children without friends
- 2017
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In: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 27:Suppl. 3
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Journal article (peer-reviewed)abstract
- Background: In childhood, relations with siblings and friends lie at the core of social interaction. Lacking either type of relationship may reflect lower levels of social support. While social support is known to be negatively associated with premature death, there are still no long-term follow-ups of mortality risks among children without siblings (‘only-children’) and children without friends (‘lonely-children’). The aim of the present study was therefore to examine and compare all-cause mortality in these two groups.Methods: Cox regression analysis was based on a Stockholm cohort born in 1953 (n = 15,117). Individuals were identified as only-children if there were no records of siblings before age 18. Derived from sociometric data collected at age 13, lonely-children were defined as not being nominated by classmates as one of three best friends. The follow-up of all-cause mortality covered ages 20-56.Results: Both only-children and lonely-children had increased risks of premature mortality. When adjusted for a wide range of family-related and individual factors, the risk ratio for only-children increased in strength whereas the risk ratio for lonely-children was reduced. The former finding may be explained by suppressor effects: for example, both only-children and those whose parents had alcohol problems had higher mortality risks but only-children were less likely to have parents with alcohol problems. The latter finding was primarily due to adjustment for scholastic ability.Conclusions: It is concluded that while only-children and lonely-children have similar risks of all-cause mortality, the processes leading up to premature death appear to be rather different. Yet, interventions targeted at improving social learning experiences may be beneficial for both groups.Key messages:Only-children have higher risks of premature mortality but the mechanisms remain unclear.Lonely-children are at risk of premature mortality primarily due to poorer scholastic ability.
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17. |
- Almquist, Ylva B., 1983-, et al.
(author)
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Peer acceptance in the school class and subjective health complaints : a multilevel approach
- 2013
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In: Journal of School Health. - : Wiley. - 0022-4391 .- 1746-1561. ; 83:10, s. 690-696
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Journal article (peer-reviewed)abstract
- BACKGROUND: Feeling accepted by peers is important for young people's health but few studies have examined the overall degree of acceptance in school and its health consequences. The purpose of the study was to investigate whether health complaints among Swedish students can be attributed to the acceptance climate in their school class even when the health effects of their own (individual) acceptance score have been taken into account. METHODS: The data used were from the Health Behaviour in School-aged Children (HBSC) study for the years 2001 to 2002, 2005 to 2006, and 2009 to 2010, consisting of 13,902 5th-, 7th-, and 9th-grade Swedish students nested into 742 school classes. The statistical analyses were performed by means of linear regression multilevel analysis. RESULTS: The results indicated that the variation in subjective health complaints could be ascribed partly to the school-class level (boys: 5.0%; girls: 13.5%). Peer acceptance at the individual level demonstrated a clear association with health: the lower the acceptance, the higher the complaint scores. For girls, but not for boys, the overall degree of peer acceptance in the school class demonstrated a contextual effect on health, net of acceptance at the student level. Interaction analyses also revealed an increasingly favorable health among poorly accepted girls as the acceptance climate in the school class declined. CONCLUSIONS: A lower overall degree of peer acceptance in the school class is associated with poorer health among girls. However, girls who
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18. |
- Almquist, Ylva B., et al.
(author)
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Popular peers and firstborn siblings are better off
- 2017
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In: Sociologisk forskning. - : Sociologisk Forskning, Swedish Sociological Association. - 0038-0342 .- 2002-066X. ; 54:4, s. 313-317
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Journal article (peer-reviewed)abstract
- ‘The apple doesn’t fall far from the tree’ is an idiom that ultimately is reflected in the reproduction of inequality patterns across generations. Representatives of the child’s own generation, such as siblings and peers, may however play a key role by either reinforcing or counteracting this reproduction. Based on a Stockholm cohort now approaching retirement, we explore whether the inheritance of parents’ misfortunes, here reflected through poverty, varies in strength depending on the cohort members’ position in the sibship or peer group.
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19. |
- Almquist, Ylva B., et al.
(author)
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Prevailing over Adversity : Factors Counteracting the Long-Term Negative Health Influences of Social and Material Disadvantages in Youth
- 2018
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In: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 15:9
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Journal article (peer-reviewed)abstract
- Disadvantaged circumstances in youth tend to translate into poor health development. However, the fact that this is not always the case has been seen as indicative of differential resilience. The current study highlights factors outside the context of the family with the potential to counteract the long-term negative influences of social and material adversity in adolescence on general health status. This study was based on two waves of questionnaire data from the Northern Swedish Cohort. From the wave in 1981 (age 16), indicators of social and material conditions as well as factors related to school, peers, and spare time were derived. From the wave in 2008 (age 43), information about self-rated health was used. Ordinal logistic regression models (n = 908) showed that adversity in youth was associated with poorer self-rated health in midlife among men and women alike, net of health status at baseline. However, having an advantaged situation with regard to school, peers, or spare time appeared to protect against the detrimental influences of disadvantaged circumstances in the family context on subsequent health. This suggests that health-promoting interventions may benefit from focusing on contexts outside the family in their effort to strengthen processes of resilience among disadvantaged youths.
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20. |
- Almquist, Ylva B.
(author)
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School performance as a precursor of adult health : Exploring associations to disease-specific hospital care and their possible explanations
- 2013
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In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 41:1, s. 81-91
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Journal article (peer-reviewed)abstract
- Aims: While past research has shown that school performance is associated with some specific health outcomes in adulthood, few studies have taken a general approach to the link between school performance and adult disease. The aim of the present study was therefore to investigate sixth grade school performance in relation to disease-specific hospital care in adulthood and, moreover, to examine whether other conditions in childhood could account for any such associations. Methods: The data used was the Stockholm Birth Cohort, consisting of 14,294 individuals born in 1953. Associations between school performance and disease-specific hospital care were analysed by means of Cox regression. Results: Poor school performance was shown to be linked to a variety of diseases in adulthood, e.g. drug dependence, stomach ulcer, cerebrovascular diseases, and accidents. Some differences according to gender were found. Most associations, but not all, were explained by the simultaneous inclusion of various family-related and individual factors (e.g. social class, cognitive ability, and behavioural problems). Conclusions: In sum, the results of this study suggest that poor school performance may be an essential part of risk clustering in childhood with important implications for the individual's health career.
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21. |
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22. |
- Almquist, Ylva B., et al.
(author)
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Social relationships and subsequent health-related behaviours : linkages between adolescent peer status and levels of adult smoking in a Stockholm cohort
- 2012
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In: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 108:3, s. 629-637
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Journal article (peer-reviewed)abstract
- Aims: Peer status reflects the extent to which an individual is accepted by the group. Some studies have reported that low peer status in adolescence is associated with a higher risk of smoking, while others found the reverse. No studies have investigated peer status influences on adult smoking. The aim of the study was therefore to examine the relationship between adolescents' peer status and the intensity of smoking in adulthood.Design: Prospective cohort study.Setting: Stockholm, Sweden.Participants: A subsample (n = 2329) of the cohort with information about adult smoking.Measurements: Peer status was assessed sociometrically at age 13 and information on smoking was gathered through a questionnaire at age 32. Relative risks (RR) for self-reported level of smoking were calculated using multinomial logistic regression. Several family-related and individual variables were included as control variables.Findings: Lower peer status in adolescence was associated with smoking of any intensity in adulthood. For example, the risk of heavy smoking was more than threefold (RR = 3.67) among individuals in the lowest status positions. The association with occasional smoking was abolished by controlling for factors related to adolescents' attitude to school and cognitive ability. For regular and heavy smoking the relationship was attenuated by controlling for these factors.Conclusions: Low peer status in adolescence appears to be a risk factor for smoking in adulthood. Part of this association may be explained by adolescents' feelings towards school and cognitive ability. However, being unpopular in adolescence remains a strong risk factor for regular and heavy smoking in adulthood.
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23. |
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24. |
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25. |
- B. Almquist, Ylva, et al.
(author)
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Intergenerational transmission of alcohol misuse : mediation and interaction by school performance in a Swedish birth cohort
- 2020
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In: Journal of Epidemiology and Community Health. - : BMJ. - 0143-005X .- 1470-2738. ; 74:7, s. 598-604
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Journal article (peer-reviewed)abstract
- Background Children whose parents misuse alcohol have increased risks of own alcohol misuse in adulthood. Though most attain lower school marks, some still perform well in school, which could be an indicator of resilience with protective potential against negative health outcomes. Accordingly, the aim of this study was to examine the processes of mediation and interaction by school performance regarding the intergenerational transmission of alcohol misuse.Methods Data were drawn from a prospective Swedish cohort study of children born in 1953 (n=14 608). Associations between parental alcohol misuse (ages 0–19) and participants' own alcohol misuse in adulthood (ages 20–63) were examined by means of Cox regression analysis. Four-way decomposition was used to explore mediation and interaction by school performance in grade 6 (age 13), grade 9 (age 16) and grade 12 (age 19).Results Mediation and/or interaction by school performance accounted for a substantial proportion of the association between parental alcohol misuse and own alcohol misuse in adulthood (58% for performance in grade 6, 27% for grade 9 and 30% for grade 12). Moreover, interaction effects appeared to be more important for the outcome than mediation.Conclusion Above-average school performance among children whose parents misused alcohol seems to reflect processes of resilience with the potential to break the intergenerational transmission of alcohol misuse. Four-way decomposition offers a viable approach to disentangle processes of interaction from mediation, representing a promising avenue for future longitudinal research.
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26. |
- Bishop, Lauren, et al.
(author)
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Friends' childhood adversity and long-term implications for substance misuse : A prospective Swedish cohort study
- 2021
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In: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 116:3, s. 632-640
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Journal article (peer-reviewed)abstract
- Background and aims Although an individual's childhood adversity is predictive of later substance misuse, the effect of adversity within an individual's friendship network has not been established. The current study aims to estimate the strength of the association between exposure to childhood adversity among individuals' friends at the onset of adolescence, relative to individuals' own exposure to childhood adversity, and hospitalization for substance misuse between young adulthood and retirement. Design Prospective cohort study. Setting Stockholm, Sweden. Participants Individuals born in 1953, living in Stockholm in 1963, and who nominated three best friends in the 6th grade school class (n = 7180; females = 3709, males = 3471), followed to 2016. Measurements The outcome was hospitalization with a main or secondary diagnosis attributed to substance misuse, reflected in Swedish inpatient records (ages 19-63 years). Five indicators of childhood adversity (ages 0-12 years) were operationalized into composite measures for individuals and their friends, respectively. Friendships were identified using sociometric data collected in the school class setting (age 13 years). Findings Individuals' own childhood adversity does not predict childhood adversity among friends (P > 0.05). Childhood adversity among friends is independently associated with an increased risk of an individual's later substance misuse [hazard ratio (HR) = 1.17, 95% confidence interval (CI) = 1.09-1.24], independently of an individual's own childhood adversity (HR = 1.47, 95% CI = 1.34-1.61). However, childhood adversity among friends does not moderate the association between individuals' own childhood adversity and later substance misuse. Conclusions Within a birth cohort of individuals born in 1950s Stockholm, Sweden, childhood adversity among an individual's friends appears to predict the individual's substance misuse in later life independently of an individual's own exposure to childhood adversity.
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27. |
- Brolin Låftman, Sara, et al.
(author)
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Students' accounts of school-performance stress : a qualitative analysis of a high-achieving setting in Stockholm, Sweden
- 2013
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In: Journal of Youth Studies. - : Informa UK Limited. - 1367-6261 .- 1469-9680. ; 16:7, s. 932-949
-
Journal article (peer-reviewed)abstract
- The aim of the study is to examine students' experiences of school performance as a stressor. Accounts of school-performance stress at both the individual level and in relation to group mechanisms are studied through qualitative interviews with eighth-grade students in a high-performing school in Stockholm, Sweden (n=49). Using qualitative content analysis, three overarching themes emerged. Students' aspirations include accounts of students whose own high standards are a source of stress, in particular among girls. High performance as a part of their identity is a recurring topic, as well as striving for high marks for the future. External expectations comprise students' views of parents' and teachers' expectations. Generally, students feel that parents are supportive and have reasonable expectations. Students often compare themselves with high-performing siblings, which may be seen as a way of meeting indirect parental expectations. Few students mention teachers' expectations as a source of stress. The high-performing context shows that respondents bear witness to an MVG culture' meaning that many students aim for the highest possible marks. Girls in particular tend to drive up stress levels by talking to each other about pressure at school. Students also compare themselves with each other, which is experienced as competitive and stressful.
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28. |
- Brännström, Lars, 1972-, et al.
(author)
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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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In: Child Maltreatment. - : SAGE Publications. - 1077-5595 .- 1552-6119. ; 22:3, s. 205-214
-
Journal article (peer-reviewed)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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29. |
- Brännström, Lars, 1972-, et al.
(author)
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Gender-specific trajectories of offending from adolescence until age 40 among individuals with experience of out-of-home care : A national cohort study
- 2023
-
In: Developmental Child Welfare. - : Sage Publications. - 2516-1032 .- 2516-1040.
-
Journal article (peer-reviewed)abstract
- It is well-known that experiences of out-of-home care (OHC; foster-family care and residential care) are linked to criminal behavior. Less is known how criminal activity in the OHC population develops over the life course and to what extent such development is characterized by desistance or persistence. Using population-based longitudinal register data for more than 740,000 Swedish men and women, of which around 2.5% have experience of OHC, followed until age 40, results from group-based trajectory modelling and multinomial regression suggest that OHC-experienced individuals with various timing and duration of placement, especially men first placed as teenagers, have substantially elevated likelihood for persistent offending compared to peers without OHC experience. However, most OHC-experienced followed pathways characterized by desistance. Our findings have implications for understanding the dynamics of offending in OHC populations and underscores the necessity for interventions that can prevent the onset of criminal careers, as well as disrupt or modify the ongoing paths of offending within this disadvantaged group of individuals.
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30. |
- Brännström, Lars, et al.
(author)
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Inequalities in educational outcomes in individuals with childhood experience of out-of-home care : What are driving the differences?
- 2020
-
In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 15:4
-
Journal article (peer-reviewed)abstract
- BackgroundPrior research has shown that individuals with experience of out-of-home care (foster family care or residential care) in childhood are educationally disadvantaged compared to their peers. In order to be better equipped to design interventions aimed at improving the educational outcomes of children for whom society has assumed responsibility, this study seeks to further our understanding about which factors that contribute to the educational disparities throughout the life course.MethodsUsing longitudinal data from a cohort of more than 13,000 Swedes, of which around 7% have childhood experience of out-of-home care, Peters-Belson decomposition is utilized to quantify the extent to which the gap in educational achievement in school (age 16) and midlife educational attainment (age 50) captures differences in the prevalence of factors influencing educational outcomes, and differences in the impacts between these factors.ResultsWe find that the achievement and the attainment gap was around 13% and 9% respectively. These gaps were to a large extent explained by differences in the distribution of predictors. The major explanatory factor for placed children’s lower achievement was a lower average cognitive ability. Yet there were some evidence that the rewards of cognitive ability in these children differed across the life course. While the lower returns of cognitive ability suggest that they were underperforming in compulsory school, the higher returns of cognitive ability on midlife attainment indicate that–given previous underperformance–their attainment at age 50 reflects their cognitive capacity more accurately than their achievement at age 16 do.ConclusionThe large influence of the unequal distribution of predictors suggests that policy efforts are needed to promote equity in the distribution of factors contributing to educational achievement and attainment. Since cognitive ability was found to be an important contributory factor, such efforts may include promoting cognitive and intellectual development among children in out-of-home care, preferably starting at a young age.
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31. |
- Brännström, Lars, et al.
(author)
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The truly disadvantaged? Midlife outcome dynamics of individuals with experiences of out-of-home care
- 2017
-
In: International Journal of Child Abuse & Neglect. - : Elsevier BV. - 0145-2134 .- 1873-7757. ; 67, s. 408-418
-
Journal article (peer-reviewed)abstract
- Little is known about developmental outcomes in midlife of persons who were placed in out-of-home care (OHC) in childhood. Utilizing longitudinal Swedish data from a cohort of more than 14,000 individuals who we can follow from birth (1953) to the age of 55 (2008), this study examines midlife trajectories of social, economic, and health-related disadvantages with a specific focus on the complexity, timing, and duration of disadvantage in individuals with and without childhood experience of OHC. Roughly half of the OHC alumni did not have disadvantaged outcomes in midlife. However, experience of OHC was associated with a two-fold risk for various forms of permanent disadvantage, net of confounding factors. Implications for research, policy, and practice are discussed.
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32. |
- Carlson, Per, 1967-, et al.
(author)
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Are area-level effects just a proxy for school-level effects? Socioeconomic differences in alcohol consumption patterns among Swedish adolescents
- 2016
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In: Drug And Alcohol Dependence. - : Elsevier BV. - 0376-8716 .- 1879-0046. ; 166, s. 243-248
-
Journal article (peer-reviewed)abstract
- AimsAlthough recent studies have found significant variations in adolescent alcohol consumption across neighbourhoods, these investigations did not address another important context in adolescents’ lives: schools. The purpose of this study was to not only simultaneously assess variations in adolescent alcohol use and binge drinking at the city district level and the school level but also analyse whether any such variations could be ascribed to the socioeconomic characteristics of the examined city districts, schools, and students.DesignCross-sectional study.SettingStockholm, Sweden.ParticipantsNinth-grade students (n = 4349) attending schools (n = 75) located in the city districts of the Stockholm municipality (n = 14).MeasurementsTwo measures based on information regarding alcohol consumption were constructed: alcohol use (no or yes) and binge drinking among alcohol users (ranging from “very seldom” to “a few times a week”). A wide range of socioeconomic characteristics was included at the city district, school, and student levels. Alcohol use was analysed using mixed-effects logistic regression, whereas binge drinking among users was modelled using mixed-effects ordered logistic regression.FindingsThe results indicated that the school was more important than the city district in assessments of contextual variations in adolescent alcohol use in general and binge drinking in particular. Moreover, proportions of well-educated parents and high-performing students accounted for part of the school-level variation in alcohol use but not binge drinking.ConclusionsFailure to account for the school context may have caused past research to overestimate city district differences in alcohol consumption among adolescents.
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33. |
- de Oliveira, Thaís Lopes, et al.
(author)
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Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) participant's profile regarding self-rated health : a multiple correspondence analysis
- 2021
-
In: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 21:1
-
Journal article (peer-reviewed)abstract
- Background: Self-rated health (SRH) - one of the most common health indicators used to verify health conditions - can be influenced by several types of socioeconomic conditions, thereby reflecting health inequalities. This study aimed to evaluate the participant profiles regarding the association between self-rated health and social and occupational characteristics of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).Methods: Cross-sectional design, including 11,305 individuals. Self-rated health was categorized as good, fair, and poor. The relationship between socio-demographic, psychosocial work environment, health-related variables, and self-rated health was analyzed by multiple correspondence analysis (stratified by age: up to 49 years old and 50 years old or more).Results: For both age strata, group composition was influenced by socioeconomic conditions. Poor SRH was related to lower socioeconomic conditions, being women, black self-declared race/ethnicity, being non-married/non-united, low decision authority, low skill discretion, and obesity.Conclusion: To promote health, interventions should focus on reducing existing socioeconomic, race, and gender inequalities in Brazil.
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34. |
- Elling, Devy L., et al.
(author)
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Workplace alcohol prevention : are managers' individual characteristics associated with organisational alcohol policy knowledge and inclination to initiate early alcohol interventions?
- 2020
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In: International Journal of Workplace Health Management. - 1753-8351 .- 1753-836X. ; 13:5, s. 543-560
-
Journal article (peer-reviewed)abstract
- Purpose - Individual factors associated with managers' organisational alcohol policy knowledge and inclination to initiate early alcohol interventions have been understudied. This study aims to examine differences in managers' policy knowledge and inclination across a range of socio-demographic, work-related and health characteristics, and it aims to examine the association between policy knowledge and inclination to intervene, net of these characteristics.Design/methodology/approach - Questionnaire data were collected from 430 managers. Organisational alcohol policy knowledge and inclination to intervene were measured using a 5-point Likert scale ranging from 1 (very low) to 5 (very high). Socio-demographic, work-related and health characteristics included gender, age, education, managerial responsibility, years in current position, self-rated health and alcohol consumption. Associations were examined using multilevel ordinal regression analysis.Findings - Managers with a greater number of employees demonstrated the highest level of organisational alcohol policy knowledge and were more inclined to initiate early alcohol interventions. Alcohol policy knowledge was associated with inclination to intervene, net of individual characteristics.Practical implications - Considering how managers' characteristics might influence efforts to decrease hazardous alcohol consumption is potentially important when designing future workplace alcohol prevention programmes.Originality/value - Several individual factors related to managers' organisational alcohol policy knowledge and inclination to initiate early alcohol interventions were identified, particularly managerial responsibility. However, the association between policy knowledge and inclination to intervene remained strong after accounting for these individual factors. Future studies should explore alternative explanations at the individual and organisational levels.
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35. |
- Fors, Stefan, et al.
(author)
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Coexisting Social, Economic, and Health-Related Disadvantages in More than 2.4 Million Swedes : Combining Variable-Centred and Person-Centred Approaches
- 2019
-
In: Social Indicators Research. - : Springer Science and Business Media LLC. - 0303-8300 .- 1573-0921. ; 143:1, s. 115-132
-
Journal article (peer-reviewed)abstract
- The notion of coexisting disadvantages has been recognised in social welfare policy and welfare research, not least in the Nordic countries. The prevalence and patterning of coexisting disadvantages in society have far reaching implications for well-being, social policy, and social inequality. Using longitudinal register-based data for the years 1998‒2008 for all Swedish individuals born 1946‒1965 (n > 2.4 million), this exploratory study maps out the occurrence of coexisting disadvantages in the Swedish working-age population, and examines to what extent observed prevalence rates are associated with sex, age, immigrant status, and marital status. Coexisting disadvantages are analysed in terms of four broad register-based indicators intended to capture individuals’ resources in key areas of the society: education, income, labour market, and mental health. The results show that while most individuals are not disadvantaged in these areas, coexisting disadvantages do occur and its prevalence varies according to sex, age, immigrant status, and marital status. This study shows that combinations of person-centred and variable-centred analyses of register-based indicators can play a part when developing effective systems for policy surveillance.
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36. |
- Fors, Stefan, et al.
(author)
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Is childhood intelligence associated with coexisting disadvantages in adulthood? Evidence from a Swedish cohort study
- 2018
-
In: Advances in Life Course Research. - : Elsevier BV. - 1040-2608. ; 38, s. 12-21
-
Journal article (peer-reviewed)abstract
- Intelligence has repeatedly been linked to a range of different outcomes, including education, labour market success and health. Lower intelligence is consistently associated with worse outcomes. In this study, we analyzed the associations between intelligence measured in childhood, and the risk of experiencing a range of different configurations of coexisting disadvantages in adulthood. We also examined the role of educational achievements in shaping the associations. The analyses are based on the Stockholm Birth Cohort, a data material that encompasses more than 14,000 individuals born in 1953, with follow up until 2008. Latent class analysis was used to identify four different outcome configurations characterized by varying levels of disadvantages, measured in terms of unemployment, social assistance recipiency, and mental health problems. The results show that those who scored lower on an intelligence test in childhood were at an increased risk of experiencing all configurations characterized by increased levels of disadvantages during adulthood. However, these associations were contingent on educational achievement. Once the models were adjusted for school marks and educational attainment, no association between intelligence and disadvantages remained. These findings highlight the importance of developing strategies to facilitate optimal educational opportunities for all children, at all levels of cognitive performance.
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37. |
- Gao, Menghan, et al.
(author)
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Exposure to out-of-home care in childhood and adult all-cause mortality : a cohort study
- 2017
-
In: International Journal of Epidemiology. - : Oxford University Press (OUP). - 0300-5771 .- 1464-3685. ; 46:3, s. 1010-1017
-
Journal article (peer-reviewed)abstract
- Background: Children placed in out-of-home care (OHC) have exceedingly high rates of health problems. Their poor health tends to persist across adolescence and into young adulthood, resulting in increased risks of mortality. Yet, very little is known about this group’s mortality risks later in life. The aim of this study was to investigate whether OHC was associated with the risk of all-cause mortality across adulthood, and whether these risks varied across different placement characteristics. Moreover, the study addressed potential confounding by including two comparison groups with children who grew up under similarly adverse living conditions but did not experience placement.Methods: Data were derived from a 60-year follow-up of a Stockholm cohort born in 1953 (n = 15 048), of whom around 9% have had experiences of OHC. The associations between OHC and subsequent all-cause mortality were analysed by means of Cox’s proportional hazards regression models.Results: Individuals who were placed in OHC at any point during their formative years had increased mortality risks across ages 20 to 56 years. Elevated risk of mortality was particularly pronounced among those who were placed in adolescence and/or because of their own behaviours. Children who were exposed to OHC had increased risks of mortality also when compared with those who grew up under similar living conditions but did not experience placement.Conclusions: Children in OHC constitute a high-risk group for subsequent mortality. In order to narrow the mortality gap, interventions may need to monitor not only health aspects but also to target the cognitive and social development of these children.
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38. |
- Gauffin, Karl, et al.
(author)
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Rocks, Dandelions or Steel Springs : Understanding Resilience from a Public Health Perspective
- 2021
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In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:15
-
Journal article (peer-reviewed)abstract
- The multifaceted concept of resilience is widely used to describe individual or societal abilities to withstand and adjust to external pressures. In relation to health, resilience can help us to understand a positive health development despite adverse circumstances. The authors of this article aimed to disentangle this complex concept by elaborating on three metaphors commonly used to describe resilience. Similarities and differences between resilience as a rock, a dandelion, and a steel spring are discussed. The metaphors partly overlap but still provide slightly different perspectives on the development and manifestation of resilience. With reference to longitudinal studies of long-term health development, the article also elaborates on how resilience relates to temporal dimensions commonly used in epidemiological studies: age, cohort, and period. Moreover, the interaction between resilience at individual, organizational, and societal levels is discussed. In conclusion, it is argued that public health sciences have great potential to further a theoretical discussion that improves our understanding of resilience and promotes the integration of individual- and community-level perspectives on resilience.
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39. |
- Granvik Saminathen, Maria, et al.
(author)
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Effective schools, school segregation, and the link with school achievement
- 2018
-
In: School Effectiveness and School Improvement. - : Informa UK Limited. - 0924-3453 .- 1744-5124. ; 29:3, s. 464-484
-
Journal article (peer-reviewed)abstract
- This study examines whether 3 teacher-rated aspects of school effectiveness differ across school segregation profiles in Stockholm, and to what extent these indicators are associated with the academic achievement of 9th-grade students. Analyses were based on 2 cross-sectional data collections performed in 2014 and 2016, respectively (147 school units), one among teachers (n = 2,024) and the other among 9th-grade students (n = 9,151). Multilevel analysis was applied, estimating 2-level random intercept linear regression models. Results show that teachers’ ratings of school leadership, teacher cooperation, and school ethos, as well as student-reported marks differ across school segregation profiles. Findings further reveal significant associations between these school effectiveness indicators and student performance, even when taking student family background and the school’s student body composition into consideration. In part, these associations are also identified within segregation profiles. Moreover, results show that school ethos acts as a mediator between school segregation profile and student achievement.
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40. |
- Högnäs, Robin S., et al.
(author)
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Adolescent social isolation and premature mortality in a Swedish birth cohort
- 2020
-
In: Journal of Population Research. - : Springer Science and Business Media LLC. - 1443-2447 .- 1835-9469. ; 37:1, s. 1-23
-
Journal article (peer-reviewed)abstract
- Research shows consistently that social ties are important for longevity, and they may be particularly important during adolescence. An absence of social ties, or social isolation, during adolescence may adversely affect long-term health and wellbeing. While prior research has examined associations between isolation from friends and long-term health, and having no siblings and mortality, no study (of which we are aware) considers jointly both the role of having no friends and no siblings, nor more generally with whom adolescents spend time, and the risk of premature mortality. This paper extends the literature by drawing on data from the Stockholm Birth Cohort Study to examine the association between different types of social isolation during adolescence (i.e., an absence of friends, siblings, and time with other adolescents) and the risk of premature mortality by midlife. Results suggest that having no siblings, being unliked at school, and spending (mostly) no time with other adolescents, increases the risk of premature mortality. The association between being unliked and premature mortality was attenuated by demographic and adolescent characteristics. Consistent with our expectations, net of a robust set of covariates, adolescents who had no siblings and mostly spent no time with other adolescents (i.e., isolates) were the group most vulnerable to premature mortality by midlife. However, this was only true for females.
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41. |
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42. |
- Jackisch, Josephine, et al.
(author)
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Troubled childhoods cast long shadows : Childhood adversity and premature all-cause mortality in a Swedish cohort
- 2019
-
In: SSM - Population Health. - : Elsevier BV. - 2352-8273. ; 9
-
Journal article (peer-reviewed)abstract
- Experiences of childhood adversity are common and have profound health impacts over the life course. Yet, studying health outcomes associated with childhood adversity is challenging due to a lack of conceptual clarity of childhood adversity, scarce prospective data, and selection bias. Using a 65-year follow-up of a Swedish cohort born in 1953 (n = 14,004), this study examined the relationship between childhood adversity (ages 0-18) and premature all-cause mortality (ages 19-65). Childhood adversity was operationalized as involvement with child welfare services, household dysfunction, and disadvantageous family socioeconomic conditions. Survival models were used to estimate how much of the association between child welfare service involvement and mortality could be explained by household dysfunction and socioeconomic conditions. Results show that individuals who were involved with child welfare services had higher hazards of dying prematurely than their majority population peers. These risks followed a gradient, ranging from a hazard ratio of 3.08 (95% CI: 2.68-3.53) among those placed in out-of-home care, followed by individuals subjected to in-home services who demonstrated a hazard ratio of 2.53 (95% CI: 1.93-3.32), to a hazard ratio of 1.81 among those investigated and not substantiated (95% CI: 1.55-2.12). Associations between involvement with child welfare services and premature all-cause mortality were robust to adjustment for household dysfunction and disadvantageous family socioeconomic conditions. Neither household dysfunction nor socioeconomic conditions were related with mortality independent of child welfare services involvement. This study suggests that involvement with child welfare services is a viable proxy for exposure to childhood adversity and avoids pitfalls of self-reported or retrospective measures.
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43. |
- Jackisch, Josephine, 1984-
(author)
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Troubled childhoods cast long shadows : Studies of childhood adversity and premature mortality in a Swedish post-war birth cohort
- 2022
-
Doctoral thesis (other academic/artistic)abstract
- Taking a life course approach can help us to understand health inequalities. This thesis illustrates that socially-patterned childhood experiences might play a critical role for inequalities in mortality. The association between childhood adversity and premature mortality is investigated in the context of a 1953 Stockholm birth cohort. Over a series of four empirical studies, it is shown that childhood adversity is a major risk factor for premature mortality, and is a significant contributor to socioeconomic inequalities in mortality.More specifically, Study I found that indicators of early life socioeconomic disadvantage and childhood adversity were individually associated with adult mortality. When all of these co-occurring indicators were studied simultaneously, involvement with child welfare services – specifically involvement resulting in placement in out-of-home care – was the indicator most robustly associated with premature mortality in adulthood. Based on the results Study I, involvement with child welfare services was used as a proxy for childhood adversity the following three studies.Study II showed that involvement with child welfare services could explain almost half of the education and income gradients in life-expectancy between ages 29–67.Study III demonstrated that the increased mortality risk among adults who were placed in out-of-home care as children persisted to midlife. Moreover, increased mortality risks after out-of-home care were not unique to the Swedish welfare context but could be verified in a cohort from Great Britain.Finally, Study IV found that adults who experienced involvement with child welfare services not only had increased risks of major diseases in adulthood, but also had worse survival prospects after a first hospitalisation.Involvement with child welfare services, specifically placement in out-of-home care, can have consequences for socioeconomic attainment, and physical and mental health. Even in this cohort that entered adulthood during some of the most generous years of the Swedish welfare state, the unequal distribution of life chances following experiences of childhood adversity was not eliminated. These empirical studies extend our understanding of how childhood adversity contributes to the complex processes that generate inequalities in mortality. The results further indicate that it is never too early nor too late to prevent inequalities in health.
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44. |
- Kjellström, Jannike, et al.
(author)
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Lärares arbetsvillkor och hälsa efter 1990-talets skolreformer
- 2016
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In: Arbetsmarknad & Arbetsliv. - Karlstad : Karlstads universitet. - 1400-9692 .- 2002-343X. ; 22:1, s. 52-69
-
Journal article (peer-reviewed)abstract
- Den svenska skolan har genomgått omfattande strukturella förändringar under de senaste decennierna som påverkat dess inre liv och villkoren som präglar lärares yrkesvardag. I den här artikeln rapporterar vi om sambandet mellan lärares arbetsvillkor och hälsa i efterdyningarna av 1990-talets skolreformer och visar att det finns påtagliga hälsovinster för lärarna om arbetsvillkoren skulle förbättras.
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45. |
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46. |
- Kjellström, Jannike, et al.
(author)
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Support From Parents and Teachers in Relation to Psychosomatic Health Complaints Among Adolescents
- 2017
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In: Journal of research on adolescence. - : Wiley. - 1050-8392 .- 1532-7795. ; 27:2, s. 478-487
-
Journal article (peer-reviewed)abstract
- This study explores the relative contribution of parental and teacher support to adolescents’ psychosomatic health complaints, with a particular focus on gender and age differences. Based on a survey of 49,172 ninth- and eleventh-grade students in Stockholm (2006–2014), structural equation modeling results demonstrated negative associations between parental and teacher support on psychosomatic health complaints. Parental support had a stronger association with the outcome among girls than boys. It was also more important than teacher support for psychosomatic health complaints. Parental support was more important for younger girls’ health compared to older girls, with opposite patterns for teacher support. These findings highlight the need to consider gender and age to understand the links between social support and health during adolescence.
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47. |
- Landstedt, Evelina, 1978-, et al.
(author)
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Disentangling the directions of associations between structural social capital and mental health : Longitudinal analyses of gender, civic engagement and depressive symptoms
- 2016
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In: Social Science and Medicine. - : Elsevier BV. - 0277-9536 .- 1873-5347. ; 163, s. 135-143
-
Journal article (peer-reviewed)abstract
- The present paper analysed the directions of associations between individual-level structural social capital, in the form of civic engagement, and depressive symptoms across time from age 16-42 years in Swedish men and women. More specifically, we asked whether civic engagement was related to changes in depressive symptoms, if it was the other way around, or whether the association was bi-directional. This longitudinal study used data from a 26-year prospective cohort material of 1001 individuals in Northern Sweden (482 women and 519 men). Civic engagement was measured by a single-item question reflecting the level of engagement in clubs/organisations. Depressive symptoms were assessed by a composite index. Directions of associations were analysed by means of gender-separate cross-lagged structural equation models. Models were adjusted for parental social class, parental unemployment, parental health, and family type at baseline (age 16). Levels of both civic engagement and depressive symptoms were relatively stable across time. The model with the best fit to data showed that, in men, youth civic engagement was negatively associated with depressive symptoms in adulthood, thus supporting the hypothesis that involvement in social networks promotes health, most likely through provision of social and psychological support, perceived influence, and sense of belonging. Accordingly, interventions to promote civic engagement in young men could be a way to prevent poor mental health for men later on in life. No cross-lagged effects were found among women. We discuss this gender difference in terms of gendered experiences of civic engagement which in turn generate different meanings and consequences for men and women, such as civic engagement not being as positive for women's mental health as for that of men. We conclude that theories on structural social capital and interventions to facilitate civic engagement for health promoting purposes need to acknowledge gendered life circumstances. (C) 2016 Elsevier Ltd. All rights reserved.
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48. |
- Landstedt, Evelina, 1978-, et al.
(author)
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Intergenerational patterns of mental health problems : The role of childhood peer status position
- 2019
-
In: BMC Psychiatry. - : Springer Science and Business Media LLC. - 1471-244X. ; 19:1
-
Journal article (peer-reviewed)abstract
- BackgroundPast research has established the intergenerational patterning of mental health: children whose parents have mental health problems are more likely to present with similar problems themselves. However, there is limited knowledge about the extent to which factors related to the child’s own social context, such as peer relationships, matter for this patterning. The aim of the current study was to examine the role of childhood peer status positions for the association in mental health across two generations.MethodsThe data were drawn from a prospective cohort study of 14,608 children born in 1953, followed up until 2016, and their parents. Gender-specific logistic regression analysis was applied. Firstly, we examined the associations between parental mental health problems and childhood peer status, respectively, and the children’s mental health problems in adulthood. Secondly, the variation in the intergenerational patterning of mental health according to peer status position was investigated.ResultsThe results showed that children whose parents had mental health problems were around twice as likely to present with mental health problems in adulthood. Moreover, lower peer status position in childhood was associated with increased odds of mental health problems. Higher peer status appeared to mitigate the intergenerational association in mental health problems among men. For women, a u-shaped was found, indicating that the association was stronger in both the lower and upper ends of the peer status hierarchy.ConclusionsThis study has shown that there is a clear patterning in mental health problems across generations, and that the child generation’s peer status positions matter for this patterning. The findings also point to the importance of addressing gender differences in these associations.
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49. |
- Landstedt, Evelina, et al.
(author)
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The role of social position and depressive symptoms in adolescence for life-course trajectories of education and work : a cohort study
- 2016
-
In: BMC Public Health. - : BioMed Central. - 1471-2458. ; 16
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Journal article (peer-reviewed)abstract
- BACKGROUND: While a vast amount of studies confirm the social reproduction of class and status from one generation to the next, less is known about the role of health in the child generation for these processes. Research has shown that particularly mental distress in adolescence is important for future life chances. This study aimed to examine the importance of parental socioeconomic position and depressive symptoms in youth for life-course trajectories of education and labour market attachment among men and women.METHODS: Based on four waves of questionnaire data from the Northern Swedish Cohort (n = 1,001), consisting of individuals born in 1965, three steps of gender-separate analyses were undertaken. First, the individual trajectories of education and labour market attachment from age 18 to 42 were mapped through sequence analysis. Second, cluster analysis was used to identify typical trajectories. Third, two indicators of parental socioeconomic position - occupational class and employment status - and depressive symptoms at age 16 were used in multinomial regression analyses to predict adult life-course trajectories.RESULTS: Four typical trajectories were identified for men, of which three were characterised by stable employment and various lengths of education, and the fourth reflected a more unstable situation. Among women, five trajectories emerged, characterised by more instability compared to men. Low parental occupational class and unemployment were significantly associated with a higher risk of ending up in less advantaged trajectories for men while, for women, this was only the case for occupational class. Youth levels of depressive symptoms did not significantly differ across the trajectories.CONCLUSIONS: This study found support for the intergenerational reproduction of social position, particularly when measured in terms of parental occupational class. Youth depressive symptoms did not show clear differences across types of trajectories, subsequently impeding such symptoms to trigger any selection processes. While this could be a consequence of the specific framework of the current study, it may also suggest that depressive symptoms in youth are not a root cause for the more complex processes through which how social position develops across life. The possible impact of welfare and labour market policies is discussed.
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- Manhica, Hélio, et al.
(author)
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Hospital admission and criminality associated with substance misuse in young refugees – a Swedish national cohort study
- 2016
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In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 11:11
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Journal article (peer-reviewed)abstract
- BackgroundHigh rates of mental health problems have been described in young refugees, but few studies have been conducted on substance misuse. This study aimed to investigate the patterns of hospital care and criminality associated with substance misuse in refugees who settled in Sweden as teenagers.MethodsGender stratified Cox regression models were used to estimate the risks of criminal convictions and hospital care associated with substance misuse from national Swedish data for 2005–2012. We focused on 22,992 accompanied and 5,686 unaccompanied refugees who were aged 13–19 years when they settled in Sweden and compared them with 1 million native Swedish youths from the same birth cohort.ResultsThe risks of criminal conviction associated with substance misuse increased with the length of residency in male refugees, after adjustment for age and domicile. The hazard ratios (HRs) were 5.21 (4.39–6.19) for unaccompanied and 3.85 (3.42–4.18) for accompanied refugees after more than 10 years of residency, compared with the native population. The risks were slightly lower for hospital care, at 2.88 (2.18–3.79) and 2.52(2.01–3.01) respectively. Risks were particularly pronounced for male refugees from the Horn of Africa and Iran. The risks for all male refugees decreased substantially when income was adjusted for. Young female refugees had similar risks to the general population.ConclusionThe risks of criminality and hospital care associated with substance misuse in young male refugees increased with time of residency in Sweden and were associated with a low level of income compared with the native Swedish population. Risks were similar in accompanied and unaccompanied refugees.
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