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  • 1. Alm, Susanne
    et al.
    Brännström, Lars
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Framtidstro - spelar det roll var man bor?2011In: Utanförskap / [ed] Alm, Susanne, Stockholm: Dialogos Förlag, 2011, p. 211-242Chapter in book (Other academic)
  • 2.
    Almquist, Ylva B.
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Brännström, Lars
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Childhood Adversity and Trajectories of Disadvantage Through Adulthood: Findings from the Stockholm Birth Cohort Study2018In: Social Indicators Research, ISSN 0303-8300, E-ISSN 1573-0921, Vol. 136, no 1, p. 225-245Article in journal (Refereed)
    Abstract [en]

    Children whose parents experience adverse social, economic, or health-related living conditions are more likely to face similar types of disadvantage in their adult life. However, a limitation of many earlier studies is that they do not account for the multidimensionality of the concept of living conditions, and that the child generation’s life courses are targeted as static and independent from the societal context in which they are imbedded. The current investigation addressed these aspects by focusing on the complexity, duration, and timing of disadvantage with regard to how adverse circumstances in the family of origin are associated with trajectories of social, economic, and health-related living conditions across adulthood. We also examined the role of educational attainment for these associations. Analyses were based a Swedish cohort born in 1953 (n = 14,294). We first conducted sequence analysis, followed by hierarchical cluster analysis, to generate ‘outcome profiles’, i.e. trajectories of adult disadvantage. Second, several indicators of adverse circumstances in childhood were analysed by means of multinominal regression analysis, showing the odds of ending up in the different trajectories. The results indicated that individuals who grew up under adverse conditions were more likely to experience disadvantaged social, economic, and health-related trajectories. This was particularly the case for trajectories characterised by a high degree of complexity, i.e. coexisting disadvantages, and—among men only—by a longer duration of disadvantage. Educational attainment was identified as a powerful mediator, suggesting that efforts to increase equal educational opportunity may be a way of reducing the intergenerational transmission of disadvantage.

  • 3.
    Almquist, Ylva B.
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Brännström, Lars
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Childhood friendships and the clustering of adverse circumstances in adulthood - a longitudinal study of a Stockholm cohort2013In: Longitudinal and life course studies, ISSN 1124-9064, E-ISSN 1757-9597, Vol. 4, no 3, p. 180-195Article in journal (Refereed)
    Abstract [en]

    Friendships constitute a central feature of childhood, yet little is known about the developmental significance extending beyond childhood and adolescence. The aim of the present study was therefore to investigate the association between childhood friendships and adult outcomes. Since many outcomes in adulthood go hand in hand, the outcome pattern as a whole was targeted. Based on a longitudinal data material consisting of more than 14,000 individuals born in Stockholm in 1953, a cluster analysis of adult circumstances (1992-2007) was first conducted. Second, the association between three indicators of childhood friendships (1966) and the outcome profiles was analysed by means of multinomial regression analysis. The results indicated that children who lacked leisure time friends and a best friend in the school class had increased risks of ending up in the more adverse clusters as adults, whereas the opposite association was found for those who reported being solitary. The effect of childhood friendships was rather consistent across both single and multiple problems, suggesting that the disadvantages of being without friends in childhood do not accumulate over the life course to any large extent. Generally, the results were the same for males and females. It is concluded that childhood friendships are important for adverse circumstances in adulthood, for both genders. As far as the long-lasting effects of children's friendships involve varying access to social support, school-based interventions should compensate for the scarcity of support following the lack of childhood friends.

  • 4.
    Almquist, Ylva B.
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Brännström, Lars
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Childhood Peer Status and the Clustering of Adverse Living Conditions in Adulthood2012Report (Other academic)
    Abstract [en]

    Within the context of the school class, children attain a social position in the peer hierarchy to which varying amounts of status are attached. Several studies have shown that children’s peer status is associated with a wide range of social and health-related outcomes. These studies commonly target separate outcomes, paying little attention to the fact that such circumstances are likely to go hand in hand. The overarching aim of the present study was therefore to examine the impact of childhood peer status on the clustering of living conditions in adulthood. Based on a 1953 cohort born in Stockholm, Sweden, multinomial regression analysis demonstrated that children who had lower peer status also had exceedingly high risks of ending up in more problem-burdened clusters as adults. Moreover, these associations remained after adjusting for a variety of family-related circumstances. We conclude that peer status constitutes a central aspect of children’s upbringing with important consequences for subsequent life chances, over and above the influences originating from the family.

  • 5.
    Almquist, Ylva B.
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Brännström, Lars
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Childhood Peer Status and the Clustering of Social, Economic, and Health-related Circumstances in Adulthood2014In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 105, p. 67-75Article in journal (Refereed)
    Abstract [en]

    Within the school-class context, children attain a social position in the peer hierarchy to which varying amounts of status are attached. Studies have shown that peer status – i.e. the degree of acceptance and likeability among classmates – is associated with adult health. However, these studies have generally paid little attention to the fact that health problems are likely to coincide with other adverse circumstances within the individual. The overarching aim of the current study was therefore to examine the impact of childhood peer status on the clustering of social, economic, and health-related circumstances in adulthood. Using a 1953 cohort born in Stockholm, Sweden (n = 14,294), four outcome profiles in adulthood were identified by means of latent class analysis: ‘Average’, ‘Low education’, ‘Unemployment’, and ‘Social assistance recipiency and mental health problems’. Multinomial regression analysis demonstrated that those with lower peer status had exceedingly higher risks of later ending up in the more adverse clusters. This association remained after adjusting for a variety of family-related and individual factors. We conclude that peer status constitutes a central aspect of children's upbringing with important consequences for life chances.

  • 6.
    Almquist, Ylva B.
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    Brännström, Lars
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Do trajectories of economic, work- and health-related disadvantages explain child welfare clients’ increased mortality risk? A prospective cohort study2019In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 19, article id 418Article in journal (Refereed)
    Abstract [en]

    Background

    Past 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.

    Methods

    Utilising 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.

    Results

    The 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.

    Conclusions

    Individuals 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.

  • 7.
    Almquist, Ylva B.
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences.
    Jackisch, Josephine
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences.
    Forsman, Hilma
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Gauffin, Karl
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences.
    Vinnerljung, Bo
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences.
    Brännström, Lars
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    A decade lost: does educational success mitigate the increased risks of premature death among children with experience of out-of-home care?2018In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 72, no 11, p. 997-1002Article in journal (Refereed)
    Abstract [en]

    Background: Past research has consistently identified children with experience of out-of-home care (OHC) as a high-risk group for premature mortality. While many have argued that educational success is a key factor in reducing these individuals’ excessive death risks, the empirical evidence has hitherto been limited. The aim of the current study was therefore to examine the potentially mitigating role of educational success for the association between OHC experience and premature mortality.

    Methods: Drawing on a Stockholm cohort born in 1953 (n=15,117), we analysed the associations between placement in OHC (ages 0-12), school performance (ages 13, 16, and 19), and premature all-cause mortality (ages 20-56) by means of Cox and Laplace regression analysis.

    Results: The Cox regression models confirmed the increased risk of premature mortality among individuals with OHC experience. Unadjusted Laplace regression models showed that these children died more than a decade, based on median survival time, before their majority population peers. However, among individuals who performed well at school, i.e. scored above-average marks at age 16 (grade 9) and age 19 (grade 12), respectively, the risks of premature mortality did not significantly differ between the two groups.

    Conclusion: Educational success seems to mitigate the increased risks of premature death among children with experience of OHC.

  • 8.
    Berg, Lisa
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences. Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Brännström, Lars
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Evicted children and subsequent placement in out-of-home care: A cohort study2018In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 4, article id e0195295Article in journal (Refereed)
    Abstract [en]

    Background

    Evictions may have serious consequences for individuals’ health and wellbeing. Even though an eviction may be experienced as a significant crisis for the family, there is little previous knowledge on consequences for evicted children. This study represents the first attempt to examine to what extent children from evicted households were separated from their parents and placed in out-of-home care (foster family or residential care) using population-based data, net of observed confounding factors related to the socioeconomic and psychosocial circumstances of their parents.

    Methods

    This study takes advantage of information from a Swedish national database, consisting of about 8 000 evicted individuals and a random sample of 770 000 individuals from the national population, linked to individual-level, longitudinal data from Swedish national registers. Our analytical sample consists of information for more than 250 000 children born in 1995–2008, including 2 224 children from evicted households. We used binary logistic regression based on the Karlson/Holm/Breen method to account for observed imbalances at baseline between evicted and non-evicted children.

    Results

    Compared to non-evicted children, the crude odds ratio for placement in out-of-home care in evicted children was 12.10 (95% CI 8.54–17.14). Net of observed confounding factors related to the socioeconomic and psychosocial circumstances of the parents, evicted children had a twofold elevated risk of being placed in out-of-home care (odds ratio 2.26, 95% CI 1.55–3.27). Crude OR for evicted children in comparison with children under threat of eviction (eviction not formally executed) was 1.71 (95% CI 1.17–2.49) and adjusted OR 1.58 (95% CI 1.06–2.35).

    Conclusion

    Children who experience eviction constitute a disadvantaged group and are at significant risk of being separated from their parents and placed in out-of-home care. These results demonstrate the importance of providing support for these children and their parents. Strategies to prevent households with children from being evicted seem to be an important and viable intervention path.

  • 9. Björkenstam, Emma
    et al.
    Burström, Bo
    Brännström, Lars
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Vinnerljung, Bo
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Björkenstam, Charlotte
    Pebley, Anne R.
    Cumulative exposure to childhood stressors and subsequent psychological distress. An analysis of US panel data2015In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 142, p. 109-117Article in journal (Refereed)
    Abstract [en]

    Research has shown that childhood stress increases the risk of poor mental health later in life. We examined the effect of childhood stressors on psychological distress and self-reported depression in young adulthood. Data were obtained from the Child Development Supplement (CDS) to the national Panel Study of Income Dynamics (PSID), a survey of US families that incorporates data from parents and their children. In 2005 and 2007, the Panel Study of Income Dynamics was supplemented with two waves of Transition into Adulthood (TA) data drawn from a national sample of young adults, 18-23 years old. This study included data from participants in the CDS and the TA (n = 2128), children aged 4-13 at baseline. Data on current psychological distress was used as an outcome variable in logistic regressions, calculated as odds ratios (OR) with 95% confidence intervals (CI). Latent Class Analyses were used to identify clusters based on the different childhood stressors. Associations were observed between cumulative exposure to childhood stressors and both psychological distress and self-reported depression. Individuals being exposed to three or more stressors had the highest risk (crude OR for psychological distress: 2.49 (95% Cl: 1.16-5.33), crude OR for self-reported depression: 2.07 (95% CI: 1.15-3.71). However, a large part was explained by adolescent depressive symptoms. Findings support the long-term negative impact of cumulative exposure to childhood stress on psychological distress. The important role of adolescent depression in this association also needs to be taken into consideration in future studies.

  • 10.
    Brännström, Lars
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Långsiktiga resultat av kontaktfamilj/person för äldre barn: en personorienterad ansats.2014Report (Other (popular science, discussion, etc.))
  • 11.
    Brännström, Lars
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Making their mark. Disentangling the Effects of Neighbourhood and School Environments on Educational Achievement2007Report (Other academic)
  • 12.
    Brännström, Lars
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Making their mark: the effects of neighbourhood and upper secondary school on educational achievement2008In: European Sociological Review, ISSN 0266-7215, E-ISSN 1468-2672, Vol. 24, no 4, p. 463-478Article in journal (Refereed)
    Abstract [en]

    This study contributes to the literature on neighbourhood and school effects on individual educational outcomes by asking whether and to what extent adolescent educational achievement in metropolitan Sweden is determined by neighbourhood and upper secondary school characteristics net of observed individual-level background attributes. Extensive cross-classified multilevel regression analyses of comprehensive leaving certificate data for around 26,000 upper secondary school students show that characteristics attributable to upper secondary schools matter much more for the variability in achievement than do neighbourhoods. There are also indications of contextual effects of neighbour and schoolmate characteristics that operate above and beyond the impact of observed individual-level background attributes. Since the estimated effects of concentrations of (dis)advantage and immigrant density at neighbourhood and school level point in different directions, this study demonstrates the benefits of analysing the effects of neighbourhood and school on individual educational outcomes at the same time.

  • 13.
    Brännström, Lars
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Neighbourhood effects on young people’s future living conditions: longitudinal findings from Sweden2012In: International Journal of Social Welfare, ISSN 1369-6866, E-ISSN 1468-2397, Vol. 21, no 4, p. 325-337Article in journal (Refereed)
    Abstract [en]

    Neighbourhood effects on young people's future living conditions: longitudinal findings from Sweden Using extensive longitudinal data for three Swedish birth cohorts born in the late 1970s, this study asked whether the social characteristics of the neighbourhood affect future outcomes that are important for their living conditions (labour-market participation, economic hardship and criminality). To assist decision-making about the balance between area-targeted policies and wider form of social interventions at the individual level, this study also assessed whether the estimated impact of neighbourhood context has any bearing on the effect of preventive interventions directed at distressed neighbourhoods. The overall findings suggest that there is no clear evidence that the impact of neighbourhood varies sufficiently between the different types of neighbourhoods when selection and other confounding factors have been taken into consideration. It is concluded that the estimated effect of neighbourhood on youth development does not underpin area-targeted policies directed at distressed neighbourhoods.

  • 14.
    Brännström, Lars
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Om särskilt kvalificerad kontaktperson - mentorskap och dess effekter2010In: Ungdomar som begår brott - Vilka insatser fungerar? / [ed] A-K. Andershed, K. Söderholm Carpelan, Stockholm: Gothia Förlag , 2010, p. 108-119Chapter in book (Other academic)
  • 15.
    Brännström, Lars
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Bo, Vinnerljung
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Child welfare clients have higher risks for teenage childbirths: which are the major confounders?2016In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 26, no 4, p. 592-597Article in journal (Refereed)
    Abstract [en]

    Background: Aiming to support effective social intervention strategies targeting high-risk groups for teenage motherhood, this study examined to what extent the elevated crude risks of teenage childbirth among child welfare groups were attributable to the uneven distribution of adverse individual and family background factors. Methods: Comprehensive longitudinal register data for more than 700 000 Swedish females born 1973–1989 (including around 29 000 child welfare clients) were analysed by means of binary logistic regression. The Karlson/Holm/Breen-method was used to decompose each confounding factor’s relative contribution to the difference between crude and adjusted odds ratios (ORs). Results: Elevated crude risks for teenage childbirth are to a large extent attributable to selection on observables. Girls’ school failure was the most potent confounder, accounting for 28–35% of the difference between crude and adjusted ORs. Conclusion: As in majority populations, girls’ school failure was a strong risk factor for teenage childbirth among former child welfare children. At least among pre-adolescents, promoting school performance among children in the child welfare system seems to be a viable intervention path.

  • 16.
    Brännström, Lars
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Forsman, Hilma
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Vinnerljung, Bo
    Stockholm University, Faculty of Social Sciences, Department of Sociology.
    Almquist, Ylva B.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    The truly disadvantaged? Midlife outcome dynamics of individuals with experiences of out-of-home care2017In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 67, p. 408-418Article in journal (Refereed)
    Abstract [en]

    Little is known about developmental outcomes in midlife of persons who were placed in out-of-home care (OHC) in childhood. Utilizing longitudinal Swedish data from a cohort of more than 14,000 individuals who we can follow from birth (1953) to the age of 55 (2008), this study examines midlife trajectories of social, economic, and health-related disadvantages with a specific focus on the complexity, timing, and duration of disadvantage in individuals with and without childhood experience of OHC. Roughly half of the OHC alumni did not have disadvantaged outcomes in midlife. However, experience of OHC was associated with a two-fold risk for various forms of permanent disadvantage, net of confounding factors. Implications for research, policy, and practice are discussed.

  • 17.
    Brännström, Lars
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Karlsson, Henrik
    Vinnerljung, Bo
    Stockholm University, Faculty of Social Sciences, Department of Social Work. Karolinska Institutet, Sweden.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Childhood risk factors for disability pension among adult former Swedish child welfare clients: Same or different as for majority population peers?2018In: Children and youth services review, ISSN 0190-7409, E-ISSN 1873-7765, Vol. 84, p. 94-102Article in journal (Refereed)
    Abstract [en]

    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.

  • 18.
    Brännström, Lars
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Kaunitz, Catrine
    Andershed, Anna-Karin
    South, Sandra
    Smedslund, Geir
    Aggression replacement training (ART) for reducing antisocial behavior in adolescents and adults: A systematic review2016In: Aggression and Violent Behavior, ISSN 1359-1789, E-ISSN 1873-6335, Vol. 27, p. 30-41Article, review/survey (Refereed)
    Abstract [en]

    Objective

    Aggression Replacement Training (ART) is a multimodal program aiming at replacing antisocial behaviors by actively teaching desirable behaviors. The program is frequently used and has been provided within a wide variety of settings, but its effectiveness in its own right has not been addressed in previous reviews. This systematic review examines the effect of ART on antisocial behavior in young people and adults.

    Methods

    Published and unpublished literature was searched to identify randomized and non-randomized studies comparing ART for adults and youth with usual care, other interventions, or no intervention. Primary outcomes included recidivism in antisocial behavior, while secondary outcomes were related to social skills, anger management and moral reasoning.

    Findings

    This review identified 16 studies with considerable clinical and methodological diversity. The methodological quality and the post-intervention follow-up of the studies were limited. Almost half of the studies were conducted by researchers who have vested interests in the intervention.

    Conclusions

    There is an insufficient evidence-base to substantiate the hypothesis that ART has a positive impact on recidivism, self-control, social skills or moral development in adolescents and adults. Further research is warranted by independent investigators exploring the effects of ART on clearly-defined target groups using high standard evaluation designs.

  • 19.
    Brännström, Lars
    et al.
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Nyström, M.
    Om ungdomstjänst och dess effekter2010In: Ungdomar som begår brott : vilka insatser fungerar? / [ed] A-K. Andershed, K. Söderholm Carpelan, Stockholm: Gothia Förlag , 2010, p. 103-107Chapter in book (Other academic)
  • 20.
    Brännström, Lars
    et al.
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Rojas, Yerko
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Rethinking the Long-term Consequences of Growing up in a Disadvantaged Neighbourhood: Lessons from Sweden2012In: Housing Studies, ISSN 0267-3037, E-ISSN 1466-1810, Vol. 27, no 6, p. 729-747Article in journal (Refereed)
    Abstract [en]

    Using extensive longitudinal register data for more than 80 000 young metropolitan Swedes, this study addresses the effect of a disadvantaged neighbourhood social context on groupings of outcomes that are important for the living conditions of young adults. The overall results show that growing up in a disadvantaged neighbourhood increases the risk of experiencing comparably more unemployment, having less education and receiving more social assistance than similar young people from more affluent neighbourhoods. However, when the estimated effects of neighbourhood are assessed by means of an epidemiological impact measure that takes the prevalence of the risk factor at population level into account; these effects prove to be minimal. We discuss possible drawbacks of placing too much emphasis on policies targeting disadvantaged neighbourhoods versus universal social policy measures.

  • 21.
    Brännström, Lars
    et al.
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Sellström, Eva
    Inst. f. hälsovetenskap, Östersund, Mittuniversitet.
    Arnoldsson, Göran
    Statistiska insitututionen, Umeå universitet.
    Boendesegregationens konsekvenser för ungdomars framtida levnadsförhållanden2010In: Social Rapport 2010, socialstyrelsen , 2010, p. 204-220Chapter in book (Other academic)
  • 22.
    Brännström, Lars
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Trolldal, Björn
    Menke, Martin
    Stockholm University, Faculty of Social Sciences, Department of Human Geography.
    Spatial spillover effects of a community action programme targeting on-licensed premises on violent assaults: evidence from a natural experiment2016In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 70, no 3, p. 226-230Article in journal (Refereed)
    Abstract [en]

    Background Spatial dependencies may influence the success of community action strategies to prevent and reduce harmful alcohol use. This study examined the effectiveness of a multicomponent Responsible Beverage Service (RBS) programme targeting on-licensed premises on police-recorded assaults in Swedish municipalities. It was expected that the implementation of the programme within any given municipality had an indirect effect by reducing violent assaults in adjacent municipalities.

    Methods This study was a natural experiment exploiting the temporal and spatial variation in the implementation of the RBS programme to predict change in the rate of violent assaults in all Swedish municipalities during 1996–2009 (n=288; T=14; N=4 032). Yearly police-recorded violent assaults per 100 000 inhabitants aged 15 and above committed on weekend nights were used as a dependent variable. Programme fidelity was identified by means of survey data. A semilogarithmic fixed-effects spatial panel regression model was used to estimate the direct, indirect and total effects of the programme.

    Results The direct, indirect and total effects were −1.8% (95% CI −4.4% to 0.8%), −5.8% (95% CI −11.5% to −0.1%) and −7.6% (95% CI −13.2% to −2.2%), respectively. Averaged over time and across all municipalities, implementing one additional programme component in all municipalities will thus reduce violent assaults in one typical municipality by nearly 8%.

    Conclusions The indirect effect of the programme was three times larger than its direct effect. Failing to account for such local spillover effects can result in a considerable underestimation of the programme's total impact and may lead to erroneous policy recommendations.

  • 23.
    Brännström, Lars
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Vinnerljung, Bo
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Kontaktfamilj/person för yngre och äldre barn: Har insatsens varaktighet och ansamlingar av ogynnsamma omständigheter under barnens uppväxt någon betydelse för utfall på lång sikt?2015Report (Other (popular science, discussion, etc.))
    Abstract [sv]

    I denna rapport undersöks om insatsens varaktighet och ansamlingar av ogynnsamma omständigheter under uppväxten har ett samband med hur det går på längre sikt för de barn där insatsen kontaktfamilj eller kontaktperson inleddes under småbarnsåren och/eller förpuberteten. Analyserna omfattar alla de barn födda i Sverige 1973-1990  där insatsen påbörjades när de var 2-5 år (n=6 693) och/eller när de var 10-13 år (n=6 389).

    Med hjälp av avancerade regressionsanalyser ser vi att sammansättningen av bakgrundsproblem inte verkar ha något tydligt specifikt samband med hur det går i framtiden. Det är antalet problem som verkar betyda något. I den yngre gruppen verkar barnen med flest problemfaktorer i hembakgrunden ha dragit nytta av längre insatstid. Där är det med andra ord möjligt att en långvarig tillgång till en kompenserande vuxenmiljö utanför den egna familjen kan ha påverkat de mest utsatta barnens utveckling på sikt. För barn med färre problemfaktorer fanns det ingen sådant samband, snarare tendenser till det omvända. Det verkar med andra ord som om en långvarig insats för de yngre barnen fungerar bättre för de ’svåraste fallen’.

    För de äldre barnen ser vi svaga tendenser till ett motsatt mönster. De med lägst antal problemfaktorer är de som verkar ha fått svag nytta av lång insatstid. Här är det viktigt att vara medveten om att vi bara har tillgång data som tyder problem i hemmet, inte hos barnet själv (t.ex. förekomsten av beteendeproblem). Det verkar med andra ord som om insatsen var för svag för de mest utsatta barnen. Den äldre gruppen hade generellt mer tecken på problem i barndomen (t.ex. höga förekomster av psykisk ohälsa hos föräldrarna) än den yngre gruppen barn. Den äldre gruppen barn verkar också ha klarat sig betydligt sämre i tonåren och i ung vuxen ålder.

    Eftersom våra sambandsanalyser inte har någon jämförelsegrupp av barn som inte fått någon insats (alla som ingår i analysen har fått mer eller mindre av insatsen) är det viktigt att påpeka att vi med det här sättet att analysera inte kan säga något om insatsen är effektiv eller inte. De mönster vi alltjämt har funnit ska därför tolkas som ’tendenser till dämpad försämring’ över tid. Det finns dock ingenting som tyder på att socialtjänsten bör vara restriktiv med att ge yngre barn från utsatta familjer en kontaktfamiljsinsats under lång tid.  För de äldre barnen finns det dessvärre inga resultat som är tillräckligt handfasta för att tjäna som underlag för rekommendationer.

  • 24.
    Brännström, Lars
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Vinnerljung, Bo
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Forsman, Hilma
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Almquist, Ylva B.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Children Placed In Out-of-Home Care as Midlife Adults: Are They Still Disadvantaged or Have They Caught Up With Their Peers?2017In: Child Maltreatment, ISSN 1077-5595, E-ISSN 1552-6119, Vol. 22, no 3, p. 205-214Article in journal (Refereed)
    Abstract [en]

    International research has consistently reported that children placed in out-of-home care (OHC) have poor outcomes in young adulthood. Yet, little is known about their outcomes in midlife. Using prospective data from a cohort of more than 14,000 Swedes born in 1953, of which nearly 9% have been placed in OHC, this study examines whether there is developmental continuity or discontinuity of disadvantage reaching into middle age in OHC children, compared to same-aged peers. Outcome profiles, here conceptualized as combinations of adverse outcomes related to education, economic hardship, unemployment, and mental health problems, were assessed in 1992–2008 (ages 39–55). Results indicate that having had experience of OHC was associated with 2-fold elevated odds of ending up in the most disadvantaged outcome profile, controlling for observed confounding factors. These findings suggest that experience of OHC is a strong marker for disadvantaged outcomes also in midlife.

  • 25.
    Brännström, Lars
    et al.
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Vinnerljung, Bo
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Effectiveness of Sweden's Contact Family/Person Program for older children2015In: Research on social work practice, ISSN 1049-7315, E-ISSN 1552-7581, Vol. 25, no 2, p. 190-200Article in journal (Refereed)
    Abstract [en]

    Objectives: To estimate the impacts of Sweden’s Contact Family/Person Program (CFPP) for older children on participants’ long-term outcomes related to mental health problems, illicit drug use, public welfare receipt, placement in out-of-home care, educational achievement, and offending. Method: We analyzed longitudinal register data on more than 1,000,000 individuals born between 1973 and 1984, including 6,386 individuals who entered CFPP at 10–13 years of age, with a follow-up until 2008. The program impact was estimated by means of propensity score matching. Results: Outcomes for those who had received the intervention were not better than that for matched peers who did not receive the intervention. Conclusions: The results did not find support for CFPP effectiveness in reducing risks of compromised long-term development in older children.

  • 26.
    Brännström, Lars
    et al.
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Vinnerljung, Bo
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Long-term outcomes of Sweden’s Contact Family Program for children2012Report (Other academic)
  • 27.
    Brännström, Lars
    et al.
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Vinnerljung, Bo
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Long-term outcomes of Sweden's Contact Family Program for children2013In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 37, no 6, p. 404-414Article in journal (Refereed)
    Abstract [en]

    Objectives: To assess the long-term impacts of Sweden's Contact Family Program (CFP) for children on participants' future outcome profiles, here conceptualized as combinations of outcomes related to mental health problems, public welfare receipt, illicit drug use, placement in out-of-home care, educational achievement, and offending. Methods: We analyzed longitudinal register data on more than 950,000 children born 1980-90, including 6693 children who entered CFP at 2-5 years of age, with a follow-up until 2008. Children's outcome profiles were identified by latent class analysis. The average program impact was estimated by means of propensity score matching. Results: Long-term outcomes for those who had received the intervention were not better than for matched peers who did not receive the intervention. Simulation-based sensitivity analyses indicate that some of our estimated negative treatment effects may be affected by unobserved factors related to program participation and outcomes. However, both selection and outcome effects must be extremely strong in order to generate notable positive effects of CFP participation. Conclusions: The results did not find support for CFP effectiveness in reducing risks of compromised long-term development in children. Since the intervention reaches a high-risk group of children and is popular among users, volunteer families and professionals, the program should be reinforced with knowledge-based components that target known risk factors for child welfare recipients.

  • 28.
    Brännström, Lars
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Vinnerljung, Bo
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Risk factors for teenage childbirths among child welfare clients: findings from Sweden2015In: Children and youth services review, ISSN 0190-7409, E-ISSN 1873-7765, Vol. 53, no 6, p. 44-51Article in journal (Refereed)
    Abstract [en]

    This study contributes to the literature on preventing teenage childbirths by asking whether the pattern and strength of risk factors is the same for high-risk child welfare clients, as for their peers in the majority population. Longitudinal register data on more than 700,000 Swedish females, including around 29,000 child welfare clients, were analyzed by means of linear probability models and calculations of population attributable fractions. Comparisons of effect sizes suggest that the differences in pattern were marginal, but there were notable differences in strength. The girls' school failure was the most prominent risk factor across all groups, also when prevalence was taken into account. In the majority population, the hypothetical reduction of teenage childbirths is on the scale of 30% if this risk factor could be eliminated. In the child welfare subgroups, however, the hypothetical improvement was even larger, around 40%. Reducing the high rate of school failure could thus yield a profound reduction in teenage childbirths in child welfare subgroups, where the incidence of teenage childbirth is substantially higher compared to other peers.

  • 29. Bøg, Martin
    et al.
    Filges, Trine
    Brännström, Lars
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Klint Jørgensen, Anne-Marie
    Kärrman Fredriksson, Maja
    12-step programs for reducing illicit drug use2017In: Campbell systematic reviews, E-ISSN 1891-1803, Vol. 13, no 2Article, review/survey (Refereed)
    Abstract [en]

    This Campbell systematic review examines the effectiveness of 12-step programs in reducing the use of illicit drugs. The review summarises findings from 10 studies, nine of which were conducted in the US.

  • 30.
    Forsman, Hilma
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Brännström, Lars
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Vinnerljung, Bo
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Does poor school performance cause later psychosocial problems among children in foster care? Evidence from national longitudinal registry data2016In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 57, p. 61-71Article in journal (Refereed)
    Abstract [en]

    Research has shown that children in foster care are a high-risk group for adverse economic, social and health related outcomes in young adulthood. Children's poor school performance has been identified as a major risk factor for these poor later life outcomes. Aiming to support the design of effective intervention strategies, this study examines the hypothesized causal effect of foster children's poor school performance on subsequent psychosocial problems, here conceptualized as economic hardship, illicit drug use, and mental health problems, in young adulthood. Using the potential outcomes approach, longitudinal register data on more than 7500 Swedish foster children born 1973–1978 were analyzed by means of doubly robust treatment-effect estimators. The results show that poor school performance has a negative impact on later psychosocial problems net of observed background attributes and potential selection on unobservables, suggesting that the estimated effects allow for causal interpretations. Promotion of school performance may thus be a viable intervention path for policymakers and practitioners interested in improving foster children's overall life chances.

  • 31.
    Fridell Lif, Evelina
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Brännström, Lars
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Vinnerljung, Bo
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Childhood Adversities and Later Economic Hardship among Swedish Child Welfare Clients: Cumulative Disadvantage or Disadvantage Saturation?2017In: British Journal of Social Work, ISSN 0045-3102, E-ISSN 1468-263X, Vol. 47, no 7, p. 2137-2156Article in journal (Refereed)
    Abstract [en]

    National register data were used in a longitudinal design to test two competing hy-potheses regarding links between cumulative exposure to childhood adversities andlater adverse outcomes, conceptualised as economic hardship in early adulthood,among more than 11,000 Swedish youths who had received the same in-home childwelfare intervention at ages two to five or at ages ten to thirteen. The cumulative-disadvantage perspective argues that the accumulation of childhood adversitiesincrease the likelihood of negative outcomes later in life. In contrast, thedisadvantage-saturation perspective suggests that the accumulation of childhood ad-versities is less consequential for initially disadvantaged individuals. Results from logis-tic regression analyses showed a pronounced positive association between theaccumulation of childhood adversities and economic hardship (measured as extensivemeans-tested social assistance recipiency) in early adulthood. After adjustments forsocio-economic confounders, the analyses showed that youth exposed to four or morechildhood adversities during childhood had two- to four-fold elevated odds of receiv-ing extensive social assistance compared to peers who had received the same inter-vention, but had no indications of exposure to childhood adversities. The results lendsupport to the relevance of accumulated childhood adversities for understandinglong-term outcomes in child welfare populations.

  • 32.
    Gao, Menghan
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Brännström, Lars
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Almquist B., Ylva
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Exposure to out-of-home care in childhood and adult all-cause mortality: a cohort study2017In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 46, no 3, p. 1010-1017Article in journal (Refereed)
    Abstract [en]

    Background: Children placed in out-of-home care (OHC) have exceedingly high rates of health problems. Their poor health tends to persist across adolescence and into young adulthood, resulting in increased risks of mortality. Yet, very little is known about this group’s mortality risks later in life. The aim of this study was to investigate whether OHC was associated with the risk of all-cause mortality across adulthood, and whether these risks varied across different placement characteristics. Moreover, the study addressed potential confounding by including two comparison groups with children who grew up under similarly adverse living conditions but did not experience placement.

    Methods: Data were derived from a 60-year follow-up of a Stockholm cohort born in 1953 (n = 15 048), of whom around 9% have had experiences of OHC. The associations between OHC and subsequent all-cause mortality were analysed by means of Cox’s proportional hazards regression models.

    Results: Individuals who were placed in OHC at any point during their formative years had increased mortality risks across ages 20 to 56 years. Elevated risk of mortality was particularly pronounced among those who were placed in adolescence and/or because of their own behaviours. Children who were exposed to OHC had increased risks of mortality also when compared with those who grew up under similar living conditions but did not experience placement.

    Conclusions: Children in OHC constitute a high-risk group for subsequent mortality. In order to narrow the mortality gap, interventions may need to monitor not only health aspects but also to target the cognitive and social development of these children.

  • 33.
    Hjern, Anders
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences. Karolinska Institutet, Sweden.
    Vinnerljung, Bo
    Stockholm University, Faculty of Social Sciences, Department of Social Work. Karolinska Institutet, Sweden.
    Brännström, Lars
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Outcomes in adulthood of adoption after long-term foster care: a sibling study2019In: Developmental Child Welfare, ISSN 2516-1032, Vol. 1, no 1, p. 61-75Article in journal (Refereed)
    Abstract [en]

    Prior research has reported a positive impact of adoption on developmental outcomes for children with experience of foster care. To inform decisions about permanent care arrangements, we used Swedish national population registers to create a sibling population consisting of 194 children born 1973–1982 who had been in out-of-home care (OHC) at least 5 years before adolescence but were never adopted (50% boys) and their 177 maternal birth siblings who also had been in OHC at least 5 years before their teens but were adopted before adolescence (52.5% boys). We constructed 14 outcome variables spanning social, educational, and health outcomes in adult age with information from Swedish national registers. Based on multilevel logistic random effects and fixed effects regression models (supplemented with a sensitivity analysis assessing the potential impact of unobserved confounding), results showed that adopted siblings tended to have considerably better outcomes in adult age in educational achievement, income, criminality, disability, and suicidality. Outcomes related to mental health and substance abuse were more similar, but differences pointed in the same direction. Implications for child welfare policy and practice are discussed.

  • 34.
    Kahlmeter, Anna
    et al.
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Bäckman, Olof
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Brännström, Lars
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Housing Evictions and Economic Hardship. A Prospective Study2018In: European Sociological Review, ISSN 0266-7215, E-ISSN 1468-2672, Vol. 34, no 1, p. 106-119Article in journal (Refereed)
    Abstract [en]

    Research has demonstrated that evictions primarily affect vulnerable populations. However, relatively little is known about the consequences eviction has, particularly regarding economic outcomes. Using comprehensive Swedish national register data on evictions in 2009, this study tests two competing hypotheses regarding to what extent an eviction affects subsequent economic hardship for an already disadvantaged group. The degree to which individuals rely on means-tested social assistance is used as an indicator of economic hardship. The cumulative disadvantage perspective predicts that additional strain will compound the economic hardship experienced by the group. In contrast, the disadvantage saturation perspective suggests that additional adversities may not add to economic hardship for disadvantaged individuals. Results from propensity score matching analyses show that, the year immediately after eviction, the degree of social assistance receipt was around 8 percentage points higher for the evicted group than for the matched comparison group. In the following 3 years, the degree of social assistance receipt continued to be significantly higher for those evicted compared to peers. The results lend support to the cumulative disadvantage perspective and suggest that—in the context of preventing evictions—policy measures such as assistance to repay rent arrears would be adequate to prevent further economic hardship.

  • 35. Löfholm, Cecilia Andree
    et al.
    Brännström, Lars
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Olsson, Martin
    Hansson, Kjell
    Treatment as usual in effectiveness studies: what is it and does it matter?2013In: International Journal of Social Welfare, ISSN 1369-6866, E-ISSN 1468-2397, Vol. 22, no 1, p. 25-34Article in journal (Refereed)
    Abstract [en]

    A hallmark of an evidence-based practice (EBP) is the systematic appraisal of research related to the effectiveness of interventions. This study addressed the issue of interpreting results from effectiveness studies that use treatment-as-usual (TAU) as a comparator. Using randomised controlled studies that evaluate the effectiveness of multisystemic therapy as an illustrative example, we show that TAU includes a wide variety of treatment alternatives. Estimated treatment effects on recidivism suggest that TAU seems to contain a greater variation in underlying risk than experimental conditions, supporting the hypothesis that the content of TAU could affect outcomes. Implications for the realisation of an EBP are discussed.

  • 36. Mattsson, P.
    et al.
    Tomson, T.
    Eriksson, Ö.
    Brännström, Lars
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Ringbäck Weitoft, G.
    Sociodemographic Differences in Antiepileptic Drug Prescriptions to Adult Epilepsy Patients2010In: Neurology, ISSN 0028-3878, E-ISSN 1526-632X, Vol. 74, no 4, p. 295-301Article in journal (Refereed)
    Abstract [en]

    Background: According to the Swedish Health Care Act, patients should be provided with the health care they need, regardless of sociodemographic status. We investigated whether in Sweden sociodemographic differences are associated with access to expert health care and antiepileptic drug (AED) prescriptions in epilepsy.Method: Patients with epilepsy were identified in the National Patient Register. Persons >=18 years on continuous AED treatment in 2006 were identified in the recently established Swedish Prescribed Drug Register. Data on sociodemographic variables were obtained from several other national registers. We linked data to examine whether epilepsy patients' access to neurologists and the prescription of individual AEDs are related to sex, age, educational level, area of residence, region of birth, or income. We also assessed whether AEDs are prescribed differently to patients with epilepsy by neurologists as compared to non-neurologists.Results: We identified 26,124 epilepsy patients in the register who were on continuous AED treatment (effective sample). Being women, young, highly educated, having high incomes, and residing in a larger city meant being more often treated by a neurologist than by other specialists. The prescriptions of AEDs differed according to gender, age, education, place of residence, and income. Lamotrigine and levetiracetam were prescribed to a larger extent by a neurologist rather than by other specialists.Conclusions: This nationwide cross-sectional study of epilepsy patients indicates that sociodemographic characteristics are important for access to neurologists and prescriptions of individual antiepileptic drugs. Prospective studies using patient-related outcomes are needed to analyze the consequences of these differences.(C)2010AAN Enterprises, Inc.

  • 37. Mattsson, Peter
    et al.
    Tomson, Torbjörn
    Edebol Eeg-Olofsson, Karin
    Brännström, Lars
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Ringbäck Weitoft, Gunilla
    Association between sociodemographic status and antiepileptic drug prescriptions in children with epilepsy2012In: Epilepsia, ISSN 0013-9580, E-ISSN 1528-1167, Vol. 53, no 12, p. 2149-2155Article in journal (Refereed)
    Abstract [en]

    Purpose: We investigated whether in Sweden sociodemographic differences are associated with access to expert health care and antiepileptic drug (AED) prescriptions in children with epilepsy.

    Methods: Data on epilepsy, prescription of AEDs, and sociodemographic variables were obtained from several national administrative registers. We linked individual data to examine whether access by pediatric epilepsy patients to neuropediatricians and the prescription of individual AEDs differed according to gender, age, parental education, place of residence, parental region of birth, and household income. We also assessed whether AEDs are prescribed differently to patients with epilepsy by neuropediatricians as compared to other physicians.

    Key Findings: Of 1,788,382 children aged 1–17 years in 2006, living in the country by the end of 2006, 9,935 had a diagnosis of epilepsy (0.56%). Patients with epilepsy on AED treatment (n = 3,631) comprised 0.24% of the total Swedish population aged 1–17 years. Out of 3631 patients with epilepsy on AED treatment, 2301 (63.4%) received prescriptions from a neuropediatrician. Children with epilepsy aged 1–5 years old—as opposed to older children and adolescents—and children with epilepsy residing in large cities—as opposed to children living in smaller cities and rural areas—were more likely to be treated by a neuropediatrician. Children living in large cities received oxcarbazepine to a greater extent than children living in rural areas. Levetiracetam was prescribed more extensively to children whose parents had higher incomes. Of the five most frequently used AEDs, three (lamotrigine, oxcarbazepine, and levetiracetam) were prescribed to a larger extent by a neuropediatrician rather than by other specialists, and one AED (carbamazepine) was prescribed to a lesser extent.

    Significance: The results of this nationwide cross-sectional study of children with epilepsy are important because they show that universal coverage for medical care does not eliminate inequalities of access to health care services among children and adolescents. No data are available that can guide us as to whether the density of child neurologists is of importance to access to expert health care, but this seems likely. Prescription patterns of AEDs differ between child neurologists and other specialists.

  • 38.
    Stenberg, Sten-Åke
    et al.
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Brännström, Lars
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Unemployment as an unintended consequence of social assistance recipiency: Results from a time-series analysis of aggregated population data2009In: Sociologisk forskning, ISSN 0038-0342, no 4, p. 29-45Article in journal (Refereed)
    Abstract [en]

    Unemployment as an unintended consequence of social assistance recipiency: Results from a time-series analysis of aggregated population data Does the frequency of unemployment have a tendency to increase the number of social assistance recipients, or does the relationship work the other way around? This article Utilizes Swedish annual data on aggregated unemployment and means-tested social assistance recipiency in the period 1946-1990 and proposes a multiple time-series approach based on vector error-correction modelling to establish the direction of influence. First, we show that rates of unemployment and receipt of social assistance is co-integrated. Second, we demonstrate that adjustments to the long-run equilibrium are made through adjustments of the unemployment. This indicates that the level of unemployment reacts to changes in rates of social assistance recipiency rather than vice versa. It is also shown that lagged changes in the level of unemployment do not predict changes in rates of social assistance recipients in short-term. Together these findings demonstrate that the number of social assistance recipients does increase the number of unemployed in a period characterized by low unemployment and high employment.

  • 39. Trolldal, Björn
    et al.
    Brännström, Lars
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Paschall, Mallie J.
    Kvillemo, Pia
    Leifman, Håkan
    Ansvarsfull alkoholservering: effekter på våldsbrottsligheten i landets kommuner2012Report (Other academic)
  • 40. Trolldal, Björn
    et al.
    Brännström, Lars
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Paschall, Mallie J.
    Leifman, Håkan
    Effects of a Multi-component Responsible Beverage Service Program on Violent Assaults in Sweden2013In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 108, no 1, p. 89-96Article in journal (Refereed)
    Abstract [en]

    Aim: A multi-component Responsible Beverage Service (RBS) programme has been disseminated in Swedish municipalities. The aim of the programme is to reduce violence associated with consumption of alcohol at on-licensed premises. This study aimed to analyse the effect of the programme on police-recorded assaults after the dissemination of the programme in Swedish municipalities, 19962009.

    Design: This study is a natural experiment that uses variation in the level of implementation of the RBS programme to predict change in the rate of police-recorded assaults. Setting Swedish municipalities. Participants The municipalities included in the study initiated the RBS programme no later than 2008. On-licensed premises open during the evenings must exist. Of 290 municipalities, 237 fulfilled these requirements.

    Measurement: Programme fidelity was studied by means of several surveys. Yearly data on police-recorded assaults, per 100?000 inhabitants aged 15 and above, committed on weekend nights, were used as dependent variable. A fixed-effects panel data regression model was used to examine the effect of the programme.

    Findings: Each extension of the programme, by one component, was associated with a significant 3.1% reduction in assaults. However, this effect was seen mainly in smaller municipalities. Of the different components of the programme, the presence of a community coalition steering group had a significant effect on assaults. No significant effect was found regarding RBS training or supervision of on-licensed premises.

    Conclusion: Multi-component Responsible Beverage Service programmes can have a significant effect on police-recorded assaults even when implemented on a large scale in many communities.

  • 41.
    Vinnerljung, Bo
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Brännström, Lars
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Disability pension among adult former child welfare clients: a Swedish national cohort study2015In: Children and youth services review, ISSN 0190-7409, E-ISSN 1873-7765, Vol. 56, p. 169-176Article in journal (Refereed)
    Abstract [en]

    Using longitudinal register data on all persons born in Sweden 1973–1978, we report on prevalence of disability pension among young adults who were child welfare clients during their formative years, and explore risk factors for this long-term outcome. For most child welfare subgroups, prevalence approached or exceeded ten percent. Multivariate logistic regression analyses found high crude odds ratios of disability pension among child welfare alumni. These were substantially reduced – but not obliterated – after adjustments for a host of background factors. Decomposition analyses revealed that child welfare alumni’s poor school performance and low educational attainment accounted for most of the confounding effects. We also found that child welfare clients with a disability pension had far higher rates of psychosocial problems in their adult lives than other peers with a disability pension. Child welfare alumni should be regarded as a high risk group for future disability pension and for permanent exclusion from the labor market. Rates of suicidal behavior in adult age were extreme among some subgroups of child welfare alumni with a disability pension, which should be communicated to agencies who are likely to meet these groups (eg. primary health care).

  • 42.
    Vinnerljung, Bo
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Brännström, Lars
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Kontaktfamilj/-person för barn: Uppföljning och utvärdering med registerdata2011Report (Other academic)
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