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

Abstract

Background: Past 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 reducing these individuals' excessive death risks, empirical evidence has hitherto been limited. The aim of the current study was therefore to examine the potentially mitigating role of educational success in the association between OHC experience and premature mortality.

Methods: Drawing on a Stockholm cohort born in 1953 (n=15 117), we analysed the associations among 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 analyses.

Results: The Cox regression models confirmed the increased risk of premature mortality among individuals with OHC experience. Unadjusted Laplace regression models showed that, based on median survival time, these children died more than a decade before their majority population peers. However, among individuals who performed well at school, that is, those who scored above-average marks at the age of 16 (grade 9) and at the age of 19 (grade 12), 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 OHC experience.

Keywords: cohort studies; education; health inequalities; lifecourse / childhood circumstances; mortality.