ICON member Josephine Jackisch has published a study in Social Science & Medicine, estimating how much of the socioeconomic gradient in mortality that can be explained by exposure to childhood adversity. The findings are based on data from the Stockholm Birth Cohort Multigenerational Study.
About the study
“Child maltreatment is a leading cause of health inequality” according to a leading WHO report. This statement is often assumed, yet, the size of the contribution of childhood adversity to the adult socioeconomic gradient in mortality remains unknown. Inequalities in mortality have mostly been investigated by taking adult conditions as a starting point. The objective of this study was to quantify how much of the socioeconomic gradient in adult life expectancy is associated with childhood adversity.
Drawing on a 1953 birth cohort from Stockholm (n = 14 210), we compared inequalities in adult mortality within the full cohort to a counterfactual scenario where individuals with a history of childhood adversity (indicated by involvement with child welfare services) experienced the mortality rates of those achieving the same adult socioeconomic position, but with no history of childhood adversity. The socioeconomic gradient across education and income quintiles (attained by age 29) is measured by the slope index of inequality of temporary life expectancy (ages 29–67).
The counterfactual scenario attenuated the education gradient by 40 percent for men and 54 percent for women. Similarly, inequalities by income were reduced in the counterfactual scenario by 49 percent for men and 47 percent for women.
These results support that childhood adversity is an important determinant of inequalities in mortality. The size of their contribution is equivalent to established behavioural risk factors. Taking a life course approach might provide important policy entry points to mitigate health inequalities.
Highlights
Contributing with 40-50 of the SES-gradient in mortality, “childhood adversity might be an even more important determinant of mortality inequalities than any single health behaviour, and as important as health behaviours combined”, says Jackisch.
Based on these results, Jackisch argues that “…policy interventions to reduce inequalities that are aimed at adults might be largely ineffective. We believe that our study can help to firmly place childhood adversity on the health equity policy agenda.”
Publication details
Jackisch, J., & van Raalte, A. (2025). The contribution of childhood adversity to adult socioeconomic gradients in mortality: A Swedish birth cohort analysis. Social Science & Medicine, 365, 117627.
Read more: https://doi.org/10.1016/j.socscimed.2024.117627
Featured authors
Josephine Jackisch
Laboratory of Population Health
Max Planck Institute for Demographic Research
https://www.demogr.mpg.de/en/about_us_6113/staff_directory_1899/josephine_jackisch_4001/
