Majority Population Peers Research Articles

Critical Disability Studies, Corporeality and Child Maltreatment: Theorising the Somatechnics of Self and Other

This paper presents a bespoke postmodern reading of the corporeality and somatechnics of self and other. It situates itself within the transformative transdisciplinary space of critical disability studies. Therein, it reflects upon the speculative boundaries between self and other, in the context of childhood disability and child maltreatment. As such, how the intervals and convergent space of self and other are engendered by technologies and techniques that both safeguard and endanger disabled children, is interrogated with classic postmodern scepticism. The context is, that international evidence places the prevalence of child abuse and neglect at significantly increased levels for disabled children. This is an enduring international problem in which disabled children continue to experience rates of abuse and neglect that far surpass those for non-disabled peers. Concurrently, safeguarding efforts are undermined in ways that are grossly dissimilar to majority population peers, including significant problems in the way that disability is conceptualised and understood. Selective reading of somatic and corporeal, as well as agentic and attitudinal dimensions of the problem, hinge on the theoretical binary of self and other. The intention is to broaden the ways in which the significant problem of safeguarding of disabled children is understood. Assistive technology, surveillance techniques and temporalities, and varied relational technics of safeguarding, all help to embed a more complicated understanding of disability and child maltreatment.

Intergenerational transmission of placement in out-of-home care: Mediation and interaction by educational attainment

BackgroundPersons with childhood experiences of out-of-home care (OHC) have elevated risks of having their own children taken into societal care. High educational attainment has been linked to favorable long-term outcomes in a host of previous studies on OHC alumni. This could be indicative of resilience, which may also have protective potential against intergenerational continuity of OHC placements. ObjectiveThe present study examined the processes of mediation and interaction by educational attainment, here conceptualized as having completed upper secondary school, regarding the intergenerational transmission of placement in OHC. Participants and settingLongitudinal data came from a Swedish cohort of parents (and their children) born in 1953 (n = 11,338). MethodsAssociations between parental experience of OHC and their children's placement in OHC were analyzed by means of binary logistic regression. Four-way decomposition was used to explore mediation and interaction by parental educational attainment. ResultsThe odds of having at least one child being placed in OHC was more than six-fold (OR = 6.67, 95% CI = 5.28; 8.06) in the OHC group compared to majority population peers. Mediation and/or interaction by educational attainment accounted for a substantial proportion of the overall association (53%). Interaction effects appeared to be more important for the outcome than mediation. ConclusionsHaving completed upper secondary school seems to reflect processes of resilience with the potential to break the intergenerational transmission of placement in OHC. These findings suggest that the impact of enhanced educational attainment of OHC populations may have potential of extending into the fate of the next generation.

Troubled childhoods cast long shadows: Childhood adversity and premature all-cause mortality in a Swedish cohort.

Experiences of childhood adversity are common and have profound health impacts over the life course. Yet, studying health outcomes associated with childhood adversity is challenging due to a lack of conceptual clarity of childhood adversity, scarce prospective data, and selection bias. Using a 65-year follow-up of a Swedish cohort born in 1953 (n = 14,004), this study examined the relationship between childhood adversity (ages 0–18) and premature all-cause mortality (ages 19–65). Childhood adversity was operationalized as involvement with child welfare services, household dysfunction, and disadvantageous family socioeconomic conditions. Survival models were used to estimate how much of the association between child welfare service involvement and mortality could be explained by household dysfunction and socioeconomic conditions. Results show that individuals who were involved with child welfare services had higher hazards of dying prematurely than their majority population peers. These risks followed a gradient, ranging from a hazard ratio of 3.08 (95% CI: 2.68–3.53) among those placed in out-of-home care, followed by individuals subjected to in-home services who demonstrated a hazard ratio of 2.53 (95% CI: 1.93–3.32), to a hazard ratio of 1.81 among those investigated and not substantiated (95% CI: 1.55–2.12). Associations between involvement with child welfare services and premature all-cause mortality were robust to adjustment for household dysfunction and disadvantageous family socioeconomic conditions. Neither household dysfunction nor socioeconomic conditions were related with mortality independent of child welfare services involvement. This study suggests that involvement with child welfare services is a viable proxy for exposure to childhood adversity and avoids pitfalls of self-reported or retrospective measures.

Do trajectories of economic, work- and health-related disadvantages explain child welfare clients\u2019 increased mortality risk? A prospective cohort study

BackgroundPast research has shown that individuals who have had experiences of out-of-home care (OHC) in childhood have increased risks of premature mortality. Prior studies also suggest that these individuals are more likely to follow long-term trajectories that are characterised by economic, work-, and health-related disadvantages, compared to majority population peers. Yet, we do not know the extent to which such trajectories may explain their elevated mortality risks. The aim of this study is therefore to examine whether trajectories of economic, work-, and health-related disadvantages in midlife mediate the association between OHC experience in childhood and subsequent all-cause mortality.MethodsUtilising longitudinal Swedish data from a 1953 cohort (n = 14,294), followed from birth up until 2008 (age 55), this study applies gender-specific logistic regression analysis to analyse the association between OHC experience in childhood (ages 0–19; 1953–1972) and all-cause mortality (ages 47–55; 2000–2008). A decomposition method developed for non-linear regression models is used to estimate mediation by trajectories of economic, work-, and health-related disadvantages (ages 39–46; 1992–1999), as indicated by social welfare receipt, unemployment, and mental health problems. To account for selection processes underlying placement in OHC, an alternative comparison group of children who were investigated by the child welfare committee but not placed, is included.ResultsThe results confirm that individuals with experience of OHC have more than a two-fold increased risk of all-cause mortality, for men (OR: 2.10, 95% CI: 1.42–3.11) and women (OR: 2.23, 95% CI: 1.39–3.59) alike. Approximately one-third (31.1%) of the association among men, and one-fourth (27.4%) of the association among women, is mediated by the long-term trajectories of economic, work-, and health-related disadvantages. The group who were investigated but not placed shows similar, yet overall weaker, associations.ConclusionsIndividuals who come to the attention of the child welfare services, regardless of whether they are placed in out-of-home care or not, continue to be at risk of adverse outcomes across the life course. Preventing them from following trajectories of economic, work-, and health-related disadvantages could potentially reduce their risk of premature death.

A decade lost: does educational success mitigate the increased risks of premature death among children with experience of out-of-home care?

BackgroundPast research has consistently identified children with out-of-home care (OHC) experience as a high-risk group for premature mortality. While many have argued that educational success is a key factor in...

The life course perspective: An integrative research paradigm for examining the educational experiences of adult care leavers?

The educational progress, experiences and attainment of children in out-of-home care and care leavers continue to be an issue of concern internationally. A growing body of research from countries such as the UK, USA, and Sweden indicates that care leavers tend to have lower levels of educational attainment than their majority population peers. Recent evidence suggests that low educational attainment of individuals with care experience may be the result of a "complex combination" of various individual characteristics as well as pre- and in-care experiences (O'Higgins et al., 2015: 13).White and Wu (2014) have highlighted the value of applying a life course perspective to child welfare research noting the potential of this approach given its emphasis on social context, individual development, and the effect of change over time. This paper embraces their case by advocating for use of the life course perspective as a guiding research paradigm when investigating the educational experiences of adult care leavers. Applying a life course perspective to research in this area has the capacity to add new dimensions to our understanding of the issue. This is due to the long-term perspective that this approach takes as well as its capacity to consider the interaction of individual and social factors and change over time.The paper begins with an outline of the key themes and concepts of the life course perspective followed by an overview of existing literature related to the educational experiences and attainment of children in care and care leavers. There follows a discussion of how using this perspective as a guiding research paradigm, with its accompanying themes and concepts, may facilitate a deeper understanding of the educational progress and experiences of adult care leavers. Throughout this discussion we will draw on a composite worked-case example from an ongoing PhD study of the educational experiences of adult care leavers in Ireland to highlight the value of applying a life course perspective to this issue.

Childhood risk factors for disability pension among adult former Swedish child welfare clients: Same or different as for majority population peers?

This study contributes to the literature on preventing social exclusion, here indicated by collecting disability pension in adulthood, by asking whether the pattern and strength of childhood related risk factors is the same for high-risk child welfare clients, as for their peers in the majority population. Longitudinal register data on >500,000 Swedes, including around 18,000 former child welfare clients, were analyzed by means of linear probability models and calculations of population attributable fractions. Systematic comparisons of effect sizes suggest that the differences in pattern were marginal, but there were significant differences in strength. Overall, poor educational achievement and low educational attainment were the two most prominent risk factors across all groups, also when prevalence was taken into account. In the majority population, the hypothetical reduction of collecting disability pension was on the scale of 20% if either of the two risk factors could be eliminated. Among child welfare alumni, however, the hypothetical reduction was even larger, nearly 30% on average. Prevention strategies targeting poor school performance and low educational attainment may thus substantially reduce the prevalence of disability pension among adults with a history of child welfare involvement.

Children in Out-of-Home Care and Adult Labor-Market Attachment: A Swedish National Register Study

Using longitudinal national register data, we investigated labor-market attachment during the years 1993–1995 in Sweden for persons aged 25–35 years who had been in out-of-home care before the age of 18 in Sweden during the 1960s, 1970s, and 1980s. We consider whether an immigrant background has an additional influence on labor-market attachment. Compared to majority population peers, young persons who had been in foster care had shorter educations. Fewer had a strong labor-market attachment and more were dependent on social assistance. Results from multinomial regression models indicated that having been in foster care during childhood reduced the probability of high attachment to the labor-market and increased the probability of social assistance dependency, even after making adjustments for education, marital status, parenthood, domicile, and birth country. Few signs of additive effects from being both an immigrant and a former foster child are found.

Psychosocial Outcomes of Fetal Alcohol Syndrome in Adulthood

Primary disabilities in children prenatally exposed to alcohol have a major impact on their daily life. It is suggested that these issues persist into adulthood, but few studies have addressed the outcome in adults with prenatal exposure, especially those with fetal alcohol syndrome (FAS). The aim of this follow-up study was to investigate outcome variables, such as education, employment, health, and criminal acts, in 79 adults diagnosed with FAS. We carried out a national register-based study of 79 adults with an FAS diagnosis, at a mean age of 32. Education, social adjustment, and mental health outcomes were analyzed and compared with 3160 comparison individuals matched on age, gender, and place of birth. The FAS group was much more likely to have received special education (25% vs 2%), be unemployed (51% vs 15%), and receive a disability pension (31% vs 3%) than the comparisons, but the levels of criminal offenses were similar. The FAS group had higher hospital admission rates for alcohol abuse (9% vs 2%) and psychiatric disorders (33% vs 5%) and was more likely to be prescribed psychotropic drugs (57% vs 27%). Swedish children with FAS have quite diverse psychosocial outcomes in adulthood, considerably worse than for majority population peers. Potential risk and protective factors within the FAS group deserve study to enable development of effective interventions.

Alcohol and drug abuse among young adults who grew up in substitute care — Findings from a Swedish national cohort study

To what extent substitute long term care modifies intergenerational transmission of substance abuse has rarely been investigated. Using register data, we followed a national cohort born 1973-1985 consisting of 1012 national adoptees, 2408 former children from long term foster care, 348/846 environmental siblings of adoptees/foster children, and 952,935 majority population peers, from their 15th birthday to age 27-35. Using Cox regression, we calculated hazard ratios (HR) for hospital care and criminality associated with illicit drug/alcohol abuse, with adjustments for socio-demographic indicators of caring families, and substance abuse in caring and birth parents. Among 37% of foster children, 9% of adoptees, and 1% of majority population peers, both birth parents had indications of substance abuse. In age/sex adjusted models foster children had four to sevenfold elevated HR for substance abuse outcomes, and adoptees two to threefold HR, in comparison with majority population peers. Estimates were only marginally attenuated after adjustments for socio-demographic indicators and morbidity of caring parents. After adjustments for birth parental substance abuse, HR decreased to around 1.5 for adoptees and foster children equally. Biological children of substitute parents did not differ substantially from majority population peers.

Cognitive, educational and self-support outcomes of long-term foster care versus adoption. A Swedish national cohort study

The benefits and pitfalls of different forms of substitute care have rarely been evaluated in comparison with each other. In this study we compared outcomes in youth and young adulthood of long-term foster care and adoption for children who came into the Child Welfare system at a young age. We linked ten national registers with data covering ten national birth cohorts to compare cognitive, educational and self-support outcomes for 900 adoptees with 3100 who grew up in foster care. Outcomes for 900 000 majority population peers were assessed for descriptive purposes. Comparisons adoptees/foster children were done in linear regression models and in Cox regression models with fixed person time. We adjusted the analyses for birth parental related selection/confounding factors (mental health problems, substance abuse and maternal education), and age at placement in substitute care. Crude outcomes for both groups were substantially weaker than for majority population peers. The foster children fell clearly short of adoptees on all outcomes; school performance at 15, cognitive competence at 18, educational achievement and self-support capability in young adult years, also after adjustments for birth parent related confounders and age at placement in substitute care.

School performance at age 16 among international adoptees: A Swedish national cohort study

School performance at age 16 for 6448 intercountry adoptees to Sweden was compared with that of siblings and majority population peers. The school performance of Korean-born adoptees was on a par with nonadopted peers, but non-Korean adoptees’ school performance was lower, as was that of adoptees who were older at the time of adoption.

Educational attainments of former child welfare clients – a Swedish national cohort study

We used national register data for nearly 800,000 Swedish‐born young people in eight national birth cohorts to examine educational attainments of former child welfare clients. A total of 31,355 former child welfare clients were compared with 744,425 majority population peers. Logistic regression models were used to estimate risks of having only a basic education at time of follow‐up, and of chances of having a post‐secondary education. Odds ratios for core results were recalculated into relative risks.Compared with majority population peers with low educated mothers, children who experienced interventions before ado‐lescence, or had been in long‐term stable foster care, had a two‐ to threefold elevated relative risk of entering adult life with only a compulsory education. Youths who experienced intervention during adolescence had approximately a fourfold risk of having only basic education at the time of follow‐up. Majority population peers with low educated mothers were between two and six times more likely to have a post‐secondary degree when compared with former child welfare clients.