Abstract
BackgroundA link between low parental socioeconomic status and mental health problems in offspring is well established in previous research. The mechanisms that explain this link are largely unknown. The present study investigated whether school performance was a mediating and/or moderating factor in the path between parental socioeconomic status and the risk of hospital admission for non-fatal suicidal behaviour.MethodsA national cohort of 447 929 children born during 1973-1977 was followed prospectively in the National Patient Discharge Register from the end of their ninth and final year of compulsory school until 2001. Multivariate Cox proportional hazards and linear regression analyses were performed to test whether the association between parental socioeconomic status and non-fatal suicidal behaviour was mediated or moderated by school performance.ResultsThe results of a series of multiple regression analyses, adjusted for demographic variables, revealed that school performance was as an important mediator in the relationship between parental socioeconomic status and risk of non-fatal suicidal behaviour, accounting for 60% of the variance. The hypothesized moderation of parental socioeconomic status-non-fatal suicidal behaviour relationship by school performance was not supported.ConclusionsSchool performance is an important mediator through which parental socioeconomic status translates into a risk for non-fatal suicidal behaviour. Prevention efforts aimed to reduce socioeconomic inequalities in non-fatal suicidal behaviour among young people will need to consider socioeconomic inequalities in school performance.
Highlights
A link between low parental socioeconomic status and mental health problems in offspring is well established in previous research
This indicates that, children with low socioeconomic status (SES) face greater risk of poor school performance and, due to this fact, are overrepresented among selfinjuring youth, the effect of poor school performance on the risk of non-fatal suicidal behaviour (NFSB) seems to be equal for all SES-groups
This study demonstrated that a substantial part of the association between parental SES and NFSB could be ascribed to the intermediate effect of school performance
Summary
A link between low parental socioeconomic status and mental health problems in offspring is well established in previous research. The present study investigated whether school performance was a mediating and/or moderating factor in the path between parental socioeconomic status and the risk of hospital admission for non-fatal suicidal behaviour. It is well recognised, that children from families with low socioeconomic status (SES) suffer from poor health more often and are more likely to face a wide range of other adversities than their counterparts from families with high SES [1,2,3]. Educational outcomes, in turn, are critical to stratification processes affecting future employment opportunities and earnings potential [13]. A mounting body of literature indicates that education plays a major role in promoting mental health and preventing mental illness [16]
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