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Avoidable mortality among parents whose children were placed in care in Sweden: a population-based study
  1. Elizabeth Wall-Wieler1,
  2. Bo Vinnerljung2,3,
  3. Can Liu3,4,
  4. Leslie L Roos1,5,
  5. Anders Hjern3,4
  1. 1 Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
  2. 2 Department of Social Work, Stockholm University, Stockholm, Sweden
  3. 3 Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
  4. 4 Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
  5. 5 Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Manitoba, Canada
  1. Correspondence to Dr Elizabeth Wall-Wieler, Department of Community Health Sciences, University of Manitoba, Winnipeg, MB R3E 3P5, Canada; wallwiee{at}myumanitoba.ca

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.

  • avoidable deaths
  • cohort studies
  • epidemiology

https://doi.org/10.1136/jech-2018-210672

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    Footnotes

    • Contributors EW-W conceived the presented idea, conducted the analysis and drafted the manuscript. BV made important intellectual contributions on the Swedish Child Welfare system. AH obtained the data. AH, BV, CL and LLR reviewed the manuscript and provided significant feedback. All authors discussed the results and contributed to the final manuscript.

    • Funding This study was funded in part by a Social Science and Humanities Research Council of Canada Joseph-Armand Bombadier Canada Graduate Scholarship-Doctoral and a Michael Smith Foreign Study Supplement.

    • Competing interests None declared.

    • Patient consent Not requried.

    • Ethics approval The study was approved by the Regional Ethics Committee in Stockholm (dnr: 2010/5:1).

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

    • Data sharing statement No additional data are available.