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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?

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Research report
A decade lost: does educational success mitigate the increased risks of premature death among children with experience of out-of-home care?
  1. Ylva B Almquist1,
  2. Josephine Jackisch1,
  3. Hilma Forsman2,
  4. Karl Gauffin1,
  5. Bo Vinnerljung2,
  6. Anders Hjern1,
  7. Lars Brännström2
  1. 1 Department of Public Health Sciences, Centre for Health Equity Studies (CHESS), Stockholm University, Stockholm, Sweden
  2. 2 Department of Social Work, Stockholm University, Stockholm, Sweden
  1. Correspondence to Dr Ylva B Almquist, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS), Stockholm University, Stockholm SE-106 91, Sweden; ylva.almquist{at}su.se

Abstract

Background Past research has consistently identified children with out-of-home care (OHC) experience 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, empirical evidence has hitherto been limited. The aim of the current study was therefore to examine the potentially mitigating role of educational success in the association between OHC experience and premature mortality.

Methods Drawing on a Stockholm cohort born in 1953 (n=15 117), we analysed the associations among 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 analyses.

Results The Cox regression models confirmed the increased risk of premature mortality among individuals with OHC experience. Unadjusted Laplace regression models showed that, based on median survival time, these children died more than a decade before their majority population peers. However, among individuals who performed well at school, that is, those who scored above-average marks at the age of 16 (grade 9) and at the age of 19 (grade 12), 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 OHC experience.

  • cohort studies
  • education
  • health inequalities
  • lifecourse / childhood circumstances
  • mortality

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/jech-2018-210487

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    Footnotes

    • Contributors YBA designed the study, drafted the manuscript and conducted the main parts of the analysis. JJ assisted in the data analysis and interpretation of the results. HF contributed to the study design and revised the manuscript. KG participated in the interpretation of the results and revised the manuscript. BV and AH took part in designing the study and revised the manuscript for important intellectual content. LB designed the study and drafted parts of the manuscript. All authors approved the final version of the manuscript.

    • Funding This study was financially supported by the Swedish Research Council for Health, Working Life and Welfare (grant no 2012-0201) and the Swedish Research Council (grant no 2017-01746).

    • Competing interests None declared.

    • Patient consent Not required.

    • Ethics approval Ethical permission for the current study was obtained from the Stockholm Regional Ethics Committee (no 2016/481-31/5).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Due to ethical regulations regarding the Stockholm Birth Cohort (SBC) study, access to the data is restricted. If there is interest in the unpublished data from this research article, a request can be made to the main author, who will forward it to the steering committee of the SBC.