The Epidemiology of Out-of-Home Care for Children and Youth: A National Cohort Study

Abstract

We used data from several national registers for fifteen entire cohorts (n > 1.5 million) of Swedish children and youth to examine the influence of parental socio-economic background on the risk of entry into out-of-home care. Logistic regression models were used to analyse the statistical impact of twelve background variables, including parental psycho-social risk markers. The results confirm and expand findings from a classic study by Bebbington and Miles, published in 1989. After controlling for other background variables, including parent hospitalizations for attempted suicide, psychiatric disorders or addiction problems, children of single mothers had three to four-fold higher odds of entering care than children from two-parent households. Low maternal education and receipt of social assistance were strongly associated with higher odds for care entries. Aggregations of socio-economic risk factors increased dramatically the risk of entering care. Among pre-school children with mothers who had received basic education only, were unemployed and received social assistance during three consecutive years, one in seven was placed in care before their seventh birthday. Among same-age children from two-parent families whose mothers were educated to post-secondary level, were employed and had not received social assistance for three consecutive years in the middle of the observation period, fewer than one in 2,000 entered care.