Background Adolescent health problems are more prevalent in families with low socioeconomic position, but few studies have assessed the role of parental health in this association. This study examines the extent to which parental health problems, particularly those related to high-risk health behaviour, might explain the association between parental education and adolescent health problems due to violence, self-harm and substance use.
Methods We used longitudinal register data on a 20% representative sample of all families with children aged 0–14 years in 2000 in Finland with information on parental social background and parental and offspring health problems based on hospital discharge data. We estimated discrete-time survival models with the Karlson-Holm-Breen method on hospital admissions due to violence, self-harm and substance use among adolescents aged 13–19 years in 2001–2011 (n=145 404).
Results Hospital admissions were 2–3 times more common among offspring of basic educated parents than tertiary educated parents. Similar excess risks were observed among those with parental mental health problems and parental health problems due to violence, self-harm and substance use. The OR for offspring of basic educated parents was attenuated from OR 2.73 (95% CI 2.34 to 3.18) to OR 2.38 (2.04 to2.77) with adjustment for parental health problems, particularly those due to violence, self-harm and substance use. Having both low parental education and parental health problems showed simple cumulative effects.
Conclusions The excess risks of hospital admissions due to violence, self-harm and substance use among adolescents with lower educated parents are largely independent of severe parental health problems.
- adolescents cg
- health behaviour
- lifecourse / childhood circumstances
- social and life-course epidemiology
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Patient consent for publication Not required.
Contributors HR participated in the conception and design of the study, performed statistical analyses and wrote the first version of the manuscript. HM, LK and PM participated in the conception and design of the study and read and revised the draft versions of the manuscript.
Funding The study was supported by the Academy of Finland, grant number 294861.
Competing interests None declared.
Ethics approval Statistics Finland Board of Statistical Ethics has approved the study.
Provenance and peer review Not commissioned; externally peer reviewed.