Adverse childhood experiences and disability pension in early midlife: results from a Swedish National Cohort Study

被引:18
作者
Bjorkenstam, Emma [1 ,2 ,3 ]
Hjern, Anders [4 ,5 ]
Vinnerljung, Bo [6 ]
机构
[1] Karolinska Inst, Dept Publ Hlth Sci, Div Social Med, SE-17177 Stockholm, Sweden
[2] Univ Calif Los Angeles, Fielding Sch Publ Hlth, Dept Community Hlth Sci, Los Angeles, CA USA
[3] Univ Calif Los Angeles, Calif Ctr Populat Res, Los Angeles, CA USA
[4] Stockholm Univ, Karolinska Inst, Ctr Hlth Equ Studies, Stockholm, Sweden
[5] Karolinska Inst, Dept Med, Clin Epidemiol, Stockholm, Sweden
[6] Stockholm Univ, Dept Social Work, Stockholm, Sweden
关键词
YOUNG ADULTHOOD; PSYCHOSOCIAL PROBLEMS; SCHOOL PERFORMANCE; WELFARE CLIENTS; RISK; HEALTH; ADOLESCENCE; DISORDERS;
D O I
10.1093/eurpub/ckw233
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: Few studies have examined the association between adverse childhood experiences (ACEs) and disability pension (DP). The current study aimed to investigate the relationship between different ACEs, cumulative ACEs, and DP, and the mediating role of school performance. Methods: We used a Swedish cohort of 522 880 individuals born between 1973 and 1978. ACEs included parental death, parental substance abuse and psychiatric disorder, substantial parental criminality, household public assistance, parental DP and child welfare intervention. Estimates of risk of DP in 2008 were calculated as odds ratios (OR) with 95% confidence intervals (CIs). Results: A total of 2.3% (3.0% females, 1.7% males) received DP in 2008. All studied ACEs increased the odds for DP, particularly child welfare intervention and household public assistance. Cumulative ACEs increased the odds of DP in a graded manner. Females exposed to 4+ ACEs had a 4-fold odds (OR: 4.0, 95% CI 3.5-4.5) and males a 7-fold odds (OR: 7.1, 95% CI: 6.2-8.1). School performance mediated the ACEs-DP association. Conclusion: This study provides evidence that ACEs is associated with increased odds of DP, particularly when accumulated. The effects of ACEs should be taken into account when considering the determinants of DP, and when identifying high-risk populations.
引用
收藏
页码:472 / 477
页数:6
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