Bornscheuer Lisa, Landstedt Evelina, Gauffin Karl, Almquist Ylva B
Department of Public Health Sciences, Stockholm University, Stockholm, SE-106 91, Sweden.
Department of Social and Psychological Studies, Karlstads Universitet, Karlstad, Sweden.
BMC Public Health. 2025 Feb 2;25(1):417. doi: 10.1186/s12889-025-21531-y.
Childhood adversity places individuals in a vulnerable position, resulting in potentially enduring disadvantage across life domains like health and work. Studying the manifestation of this disadvantage is crucial for understanding which resources society can provide to mitigate or prevent it, which makes this subject a fundamental public health concern. This study investigated whether disadvantage patterns after childhood adversity differ by gender and educational level, using out-of-home care as proxy for early adversity.
We used register data from a 1953 Swedish birth cohort. Distinct profiles of socioeconomic and health disadvantage in individuals with out-of-home care experience were identified using group-based multi-trajectory modelling. Multinomial logistic regression was then used to determine whether gender and education, individually or in interaction with each other, predict group membership.
In the population without history of out-of-home care, adulthood disadvantage was highly gendered, with women being more likely to experience disadvantage related to unemployment and poor health, while criminality and substance misuse was more common among men. History of out-of-home care was associated with a general increase in adulthood disadvantage, but the gender differences were largely absent. Women in this group were however less likely than men to experience disadvantage across multiple life domains (complex disadvantage OR = 0.56, p = 0.046; unemployment-related disadvantage OR = 0.51, p = 0.005). Higher level of education was associated with reduced likelihood of membership in the group marked by disabling health disadvantage (OR = 0.55, p = 0.002) and complex disadvantage (OR = 0.37, p = 0.001). An interaction term between gender and education was not significant.
Adulthood disadvantage was more common in the group with history of out-of-home care. The gender differences in disadvantage present in the full cohort were largely attenuated among individuals with out-of-home care history. We showed that using administrative data on outcomes across multiple life domains can provide rich descriptions of adult experiences after childhood adversity. Future research could examine gender differences in mechanisms translating into resilient or vulnerable trajectories, including the protective potential of education in relation to specific disadvantage patterns.
童年逆境使个体处于脆弱境地，导致其在健康和工作等生活领域可能长期处于不利地位。研究这种不利地位的表现对于理解社会可以提供哪些资源来减轻或预防它至关重要，这使得该主题成为一个基本的公共卫生问题。本研究以家庭外照料作为早期逆境的替代指标，调查了童年逆境后的不利模式是否因性别和教育水平而异。
我们使用了来自1953年瑞典出生队列的登记数据。通过基于群体的多轨迹建模，确定了有家庭外照料经历的个体在社会经济和健康方面的不同不利状况。然后使用多项逻辑回归来确定性别和教育程度单独或相互作用是否能预测群体归属。
在没有家庭外照料史的人群中，成年期不利状况存在明显的性别差异，女性更有可能经历与失业和健康不佳相关的不利状况，而犯罪和药物滥用在男性中更为常见。家庭外照料史与成年期不利状况的普遍增加有关，但性别差异在很大程度上不存在。然而，该群体中的女性比男性在多个生活领域经历不利状况的可能性更小（复杂不利状况OR = 0.56，p = 0.046；与失业相关的不利状况OR = 0.51，p = 0.005）。较高的教育水平与处于以致残性健康不利状况为特征的群体（OR = 0.55，p = 0.002）和复杂不利状况群体（OR = 0.37，p = 0.001）的可能性降低相关。性别和教育程度之间的交互项不显著。
有家庭外照料史的群体中成年期不利状况更为常见。在整个队列中存在的不利状况性别差异在有家庭外照料史的个体中在很大程度上减弱。我们表明，使用多个生活领域结局的行政数据可以丰富地描述童年逆境后的成人经历。未来的研究可以探讨在转化为复原力或脆弱轨迹的机制中的性别差异，包括教育相对于特定不利模式的保护潜力。
