Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Department of Social Work, Stockholm University, Stockholm, Sweden.
J Epidemiol Community Health. 2018 Dec;72(12):1091-1098. doi: 10.1136/jech-2018-210672. Epub 2018 Aug 4.
Separation from one's child can have significant consequences for parental health and well-being. We aimed to investigate whether parents whose children were placed in care had higher rates of avoidable mortality.
Data were obtained from the Swedish national registers. Mortality rates among parents whose children were placed in care between 1990 and 2012 (17 503 mothers, 18 298 fathers) were compared with a 1:5 matched cohort of parents whose children were not placed. We computed rate differences and HRs of all-cause and avoidable mortality.
Among mothers, deaths due to preventable causes were 3.09 times greater (95% CI 2.24 to 4.26) and deaths due to amenable causes were 3.04 times greater (95% CI 2.03 to 4.57) for those whose children were placed in care. Among fathers, death due to preventable causes were 1.64 times greater (95% CI 1.32 to 2.02) and deaths due to amenable causes were 1.84 times greater (95% CI 1.33 to 2.55) for those whose children were placed in care. Avoidable mortality rates were higher among mothers whose children were young when placed in care and among parents whose children were all placed in care.
Parents who had a child placed in out-of-home care are at higher risk of avoidable mortality. Interventions targeting mothers who had a child aged less than 13 placed in care, and parents whose children were all placed in care could have the greatest impact in reducing avoidable mortality in this population.
与孩子分离会对父母的健康和幸福产生重大影响。我们旨在调查儿童被安置在照料机构的父母是否有更高的可避免死亡率。
数据来自瑞典国家登记处。比较了 1990 年至 2012 年间其子女被安置在照料机构的父母（17503 名母亲，18298 名父亲）与未被安置子女的 1:5 匹配队列的死亡率。我们计算了所有原因和可避免死亡率的率差和 HR。
在母亲中，由于可预防原因导致的死亡风险高出 3.09 倍（95%CI 2.24 至 4.26），由于可治疗原因导致的死亡风险高出 3.04 倍（95%CI 2.03 至 4.57），对于那些子女被安置在照料机构的母亲。在父亲中，由于可预防原因导致的死亡风险高出 1.64 倍（95%CI 1.32 至 2.02），由于可治疗原因导致的死亡风险高出 1.84 倍（95%CI 1.33 至 2.55），对于那些子女被安置在照料机构的父亲。当子女被安置在照料机构时年龄较小的母亲和所有子女都被安置在照料机构的父母，其可避免死亡率较高。
将孩子安置在家庭以外照料的父母有更高的可避免死亡率风险。针对年龄小于 13 岁的子女被安置在照料机构的母亲，以及所有子女都被安置在照料机构的父母，实施干预措施可能会对降低这一人群的可避免死亡率产生最大影响。
