Raitasalo Kirsimarja, Karjalainen Karoliina, Kärkkäinen Sanna, Kauppinen Timo M
Promotional and Preventive Work Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.
Welfare State Research Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.
Nordisk Alkohol Nark. 2024 Oct;41(5):543-556. doi: 10.1177/14550725241270203. Epub 2024 Sep 25.
Studies have shown an association between parental problematic substance use (PSU) and children's out-of-home care (OHC). But there is little researech on the kind of urban neighbourhoods in which such associations typically show up. This study aims to shed light on the associations between neighbourhood characteristics, parental PSU and children's OHC. Using register data, we explore the spatial concentration of parental PSU and children's OHC in urban areas. Register data of all children born in Finland in 2002 and their biological parents living in 14 Finnish cities were used to follow the children from birth until their 18th birthday or first OHC episode. The study looks at parental PSU andother individual-level indicators as well-as the sociodemographic neighbourhood characteristics. Cox proportional hazards modelling was used as the analysis method. Parental PSU increased the probability of children's OHC regardless of neighbourhood type. The probabilty was highest if both parents had PSU (hazard ratio [HR] = 8.05, 95% confidence interval [Cl] 6.38-10.16), but this outcome did not look the same for all neighbourhoods. The risk of children's OHC placements was higher in suburbs compared to city centres (HR = 1.76, 95% Cl 1.38-2.25). As parental substance use is a complex problem that is often intertwined with other life challenges, such as financial difficulties and mental health problems, it is insufficient to treat caregiver conditions, such as problematic substance use in isolation. Services that increase positive, pro-social connections may be lacking in the neighbourhoods with the most challenges.
研究表明，父母物质使用问题（PSU）与儿童的家庭外照料（OHC）之间存在关联。但对于这类关联通常出现的城市社区类型，相关研究较少。本研究旨在阐明社区特征、父母PSU与儿童OHC之间的关联。利用登记数据，我们探究了城市地区父母PSU和儿童OHC的空间聚集情况。使用了2002年在芬兰出生的所有儿童及其居住在14个芬兰城市的亲生父母的登记数据，对这些儿童从出生一直追踪到18岁生日或首次出现OHC事件。该研究考察了父母PSU及其他个体层面指标以及社会人口学社区特征。分析方法采用Cox比例风险模型。无论社区类型如何，父母PSU都会增加儿童OHC的可能性。如果父母双方都有PSU，这种可能性最高（风险比[HR]=8.05，95%置信区间[Cl]为6.38 - 10.16），但这种结果在所有社区并不相同。与市中心相比，郊区儿童OHC安置的风险更高（HR = 1.76，95% Cl为1.38 - 2.25）。由于父母物质使用是一个复杂的问题，常常与其他生活挑战相互交织，如经济困难和心理健康问题，孤立地处理照料者状况，如物质使用问题并不够。在挑战最大的社区可能缺乏增加积极的、亲社会联系的服务。
