RISE

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Risk and resilience: Pathways to (ill)health among men and women with experiences of childhood adversity

Information

Period

2020-2022/2023

Funder

Forte

Amount

€ 305 000

Project members
  • Ylva B Almquist | Stockholm University (PI)
  • Lisa Bornscheuer | Stockholm University
  • Lars Brännström | Stockholm University
  • Hilma Forsman | Stockholm University
  • Karl Gauffin | Stockholm University
  • Josephine Jackisch | Stockholm University
  • Anders Hjern | Karolinska Institutet
  • Bo Vinnerljung | Stockholm University

Description

The living conditions of the family are of fundamental importance for children’s health. Growing up under adverse circumstances in the home may lead to vulnerability that increases the risks for poor mental and physical health. These risks tend to persist and accumulate throughout the life course, thereby contributing to the maintenance and reinforcement of health inequalities. A large number of children experiencing adversity nevertheless fare relatively well in late life. What makes these children resilient remains overlooked, despite the potential of such knowledge to inform intervention models. The newly updated Stockholm Birth Cohort Multigenerational Study (SBC Multigen), which prospectively follows a cohort of 14,608 men and women from birth until retirement age (1953-2018), offers a unique opportunity to expand our understanding of the ways in which processes of risk and resilience may link childhood adversity to health outcomes throughout the life course. As a starting point, we will investigate how childhood adversity is associated with the risk of morbidity and mortality across adulthood, in terms of reproductive health problems, outpatient care, inpatient care, sick leave, early retirement, and premature death. Thanks to recent advances in statistical models for life course data, we are able to account for more complex patterns of health outcomes. Furthermore, we will explore a set of potentially protective factors present in contexts outside of the family, such as the school. The development of methods for decomposing statistical effects makes it possible to determine the extent to which these factors mediate (explain) and/or moderate (influence) the association between childhood adversity and health in adulthood. In addition, the gendered nature of the life course will be addressed throughout the project. Taken together, the studies comprising this project may contribute to the development of policy measures aiming to reduce health inequalities.

Key findings

Performing well in school seems to reflect processes of resilience with the potential to break the intergenerational transmission of alcohol misuse

Almquist, Bishop, Gustafsson, & Berg (2020)

The elevated risks of suicide and self-harm among individuals who experienced placement in out-of-home care remain throughout midlife and into late adulthood

Almquist, Rojas, Vinnerljung, & Brännström (2020)

Childhood adversity among an individual’s friends predicts substance misuse in later life, irrespective of the individual’s own exposure to childhood adversity

Bishop & Almquist (2020)

The poorer educational attainment among individuals with experiences of out-of-home care is largely explained by the unequal distribution of endowments and returns of these endowments

Brännström, Forsman, Vinnerljung, & Almquist (2020)

While placement in out-of-home care is negatively associated with educational attainment in midlife, the level of disadvantage seems to reach a point of saturation

Forsman & Jackisch (2021)

A broad understanding of the concept of resilience is of high relevance for public health sciences

Gauffin, Jackisch, & Almquist (2021)

Children with experiences of involvement with child welfare services have higher risks of being hospitalized and lower chances of survival after hospitalization

Jackisch & Almquist (2023)

Out-of-home care is associated with higher and accumulating mortality risks across the life course

Jackisch, Ploubidis, & Gondek (2021)

Mental health disorders among parents have direct effects on the risk of out-of-home care among children whereas out-of-home care among parents is not directly influencing the next generation’s mental health disorders

Straatmann, Jackisch, Brännström, & Almquist (2022)

Publications

  1. Almquist, Y. B., Bishop, L., Gustafsson, N. K., & Berg, L. (2020). Intergenerational transmission of alcohol misuse: mediation and interaction by school performance in a Swedish birth cohort. J Epidemiol Community Health, 74(7), 598-604.
  2. Almquist, Y. B., Rojas, Y., Vinnerljung, B., & Brännström, L. (2020). Association of child placement in out-of-home care with trajectories of hospitalization because of suicide attempts from early to late adulthood. JAMA Network Open, 3(6), e206639-e206639.
  3. Bishop, L., & Almquist, Y. B. (2021). Friends’ childhood adversity and long‐term implications for substance misuse: a prospective Swedish cohort study. Addiction, 116(3), 632-640.
  4. Brännström, L., Forsman, H., Vinnerljung, B., & Almquist, Y. B. (2020). Inequalities in educational outcomes in individuals with childhood experience of out-of-home care: What are driving the differences?. PLOS ONE, 15(4), e0232061.
  5. Forsman, H., & Jackisch, J. (2022). Cumulative childhood adversity and long-term educational outcomes in individuals with out-of-home care experience: do multiples matter for a population defined by adversity?. The British Journal of Social Work, 52(5), 2495-2514.
  6. Gauffin, K., Jackisch, J., & Almquist, Y. B. (2021). Rocks, Dandelions or Steel Springs: Understanding Resilience from a Public Health Perspective. International Journal of Environmental Research and Public Health, 18(15), 8189.
  7. Jackisch, J., & Almquist, Y. B. (2023). Childhood adversity is associated with hospitalisations and survival following external causes and non-communicable diseases: a 46-year follow-up of a Stockholm birth cohort. J Epidemiol Community Health, 77(4), 209-215.
  8. Jackisch, J., Ploubidis, G. B., & Gondek, D. (2021). Does time heal all wounds? Life course associations between child welfare involvement and mortality in prospective cohorts from Sweden and Britain. SSM-Population Health, 14, 100772.
  9. Straatmann, V. S., Jackisch, J., Brännström, L., & Almquist, Y. B. (2022). Associations between out-of-home care and mental health disorders within and across generations in a Swedish birth cohort. SSM-Population Health, 18, 101115.