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THE CONTRIBUTION OF CHILDHOOD ADVERSITY TO THE SES GRADIENT IN MORTALITY: �A Swedish birth cohort analysis

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Josephine Jackisch & Alyson van Raalte

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Climbing Mortality Models

August 2022

MAX PLANCK INSTITUTE FOR DEMOGRAPHIC RESEARCH

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LONG ASSUMED, BUT NEVER REALLY TESTED

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1953, N = 14 608

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1953

1963

1973

1983

1993

2003

2013

2020

Born in 1953

Living in Stockholm Area in 1963

Death

Age 30

Age 68

SES

  • 12% died prematurely before age 68
  • SES is measured by education (low, medium, high) and income (quintiles, based on max. income ages 25-29)
  • SES mortality gradients are slope-index of inequality (SII) in temporary life expectancy (ages 30-38)

STOCKHOLM BIRTH COHORT MULTIGENERATIONAL STUDY

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MORTALITY GRADIENT BY SOCIOECONOMIC POSITION

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MORTALITY GRADIENT BY SOCIOECONOMIC POSITION

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Slope Index of Inequality (Full pop)

Income = 3.3 Years

Education = 2.9 Years

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CHILDHOOD ADVERSITY

  • Proxied by any involvement with child welfare services (ages 0-18)
  • 20.7 % had contact with child welfare services
          • 26.7 % of men, 14.6 % of women
          • 9.6 % (men), 8.5 % (women) in out-of-home placements

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Photo by Filip Mroz on Unsplash

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1953, N = 14 608

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1953

1963

1973

1983

1993

2003

2013

2020

Born in 1953

Living in Stockholm Area in 1963

Child welfare services

Death

Age 30

Age 68

SES

STOCKHOLM BIRTH COHORT MULTIGENERATIONAL STUDY

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KAPLAN-MEIER SURVIVAL CURVES

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MORTALITY GRADIENT BY SOCIOECONOMIC POSITION

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Slope Index of Inequality (Full pop)

Income = 3.3 Years

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MORTALITY GRADIENT BY SOCIOECONOMIC POSITION

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Slope Index of Inequality (Full pop)

Income = 3.3 Years

Slope Index of Inequality (Counterfactual pop)

Income = 1.7 Years

Women

SII = 0.7 (Full population)

SII = 0.4 (Counterfactual scenario)

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ATTENUATION IN THE EDUCATION GRADIENT

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SII = 2.9 (Full population)

SII = 1.7 (Counterfactual scenario)

SII = 0.6 (Full population)

SII = 0.3 (Counterfactual scenario)

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IS CHILD ADVERSITY REALLY EXPLAINING HALF OF THE MORTALITY GRADIENT?

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“Have you found the holy grail of inequalities research”

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MAX PLANCK INSTITUTE FOR DEMOGRAPHIC RESEARCH

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IS CHILD ADVERSITY REALLY EXPLAINING HALF OF THE MORTALITY GRADIENT?

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1) Inequalities might run through different channels

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IS CHILD ADVERSITY REALLY EXPLAINING HALF OF THE MORTALITY GRADIENT?

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2) One cohort,

One city,

One country

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IS CHILD ADVERSITY REALLY EXPLAINING HALF OF THE MORTALITY GRADIENT?

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3) We can’t untangle why adversity matters

          • Trauma of adversity
          • Trauma of child welfare experiences
          • Selection mechanisms on characteristics which increase likelihood to experience child welfare contact, attain low levels of SEP, and high rates of mortality

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IMPLICATIONS

  • Our usual way of monitoring the social determinants of mortality is missing the mark
  • The generative process leading to socioeconomic gradients in mortality starts long before SEP is attained

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THANK YOU FOR YOUR ATTENTION��vanraalte@demogr.mpg.de� @AlysonVanRaalte�

THIS RESEARCH WAS SUPPORTED BY THE

EUROPEAN RESEARCH COUNCIL, GRANT 716323