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BMC Public Health
Published in: BMC Public Health 1/2012

Open Access 01-12-2012 | Research article

A national cohort study of parental socioeconomic status and non-fatal suicidal behaviour-the mediating role of school performance

Authors: Beata Jablonska, Frank Lindblad, Viveca Östberg, Lene Lindberg, Finn Rasmussen, Anders Hjern

Published in: BMC Public Health | Issue 1/2012

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Abstract

Background

A link between low parental socioeconomic status and mental health problems in offspring is well established in previous research. The mechanisms that explain this link are largely unknown. The present study investigated whether school performance was a mediating and/or moderating factor in the path between parental socioeconomic status and the risk of hospital admission for non-fatal suicidal behaviour.

Methods

A national cohort of 447 929 children born during 1973-1977 was followed prospectively in the National Patient Discharge Register from the end of their ninth and final year of compulsory school until 2001. Multivariate Cox proportional hazards and linear regression analyses were performed to test whether the association between parental socioeconomic status and non-fatal suicidal behaviour was mediated or moderated by school performance.

Results

The results of a series of multiple regression analyses, adjusted for demographic variables, revealed that school performance was as an important mediator in the relationship between parental socioeconomic status and risk of non-fatal suicidal behaviour, accounting for 60% of the variance. The hypothesized moderation of parental socioeconomic status-non-fatal suicidal behaviour relationship by school performance was not supported.

Conclusions

School performance is an important mediator through which parental socioeconomic status translates into a risk for non-fatal suicidal behaviour. Prevention efforts aimed to reduce socioeconomic inequalities in non-fatal suicidal behaviour among young people will need to consider socioeconomic inequalities in school performance.
Literature
1.
Halldorsson M, Kunst AE, Köhler L, Mackenbach JP: Socioeconomic inequalities in the health of children and adolescents. A comparative study of the five Nordic countries. Eur J Public Health. 2001, 10: 281-288.CrossRef
2.
McMunn AM, Nazroo JY, Marmot MG, Boreham R, Goodman R: Children's emotional and behavioural well-being and the family environment: findings from the Health Survey for England. Soc Sci Med. 2001, 53: 423-440. 10.1016/S0277-9536(00)00346-4.CrossRefPubMed
3.
Power C, Matthews S: Origins of health inequalities in a national population sample. Lancet. 1997, 350: 1584-1589. 10.1016/S0140-6736(97)07474-6.CrossRefPubMed
4.
Huurre T, Aro H, Rahkonen O: Well-being and health behaviour by parental socioeconomic status: a follow-up study of adolescents aged 16 until age 32 years. Soc Psychiatry Psychiatr Epidemiol. 2003, 38: 249-255. 10.1007/s00127-003-0630-7.CrossRefPubMed
5.
Weitoft GR, Hjern A, Haglund B, Rosen M: Mortality, severe morbidity, and injury in children living with single parents in Sweden: a population-based study. Lancet. 2003, 361: 289-295. 10.1016/S0140-6736(03)12324-0.CrossRefPubMed
6.
Power C, Stansfeld SA, Matthews S, Manor O, Hope S: Childhood and adulthood risk factors for socio-economic differentials in psychological distress: evidence from the 1958 British birth cohort. Soc Sci Med. 2002, 55: 1989-2004. 10.1016/S0277-9536(01)00325-2.CrossRefPubMed
7.
Erikson R, Jonson J: Can Education be Equalized. The Swedish Case in Comparative Perspective. 1996, New York: Westview Press
8.
Jonsson JO: Utbildning som resurs under skoltiden och för framtiden: uppväxtfamilj och skolgång (Education as a resource in schooling and for the future: family and schooling). Barn och ungdomars välfärd. Edited by: Jansson S, Östberg V. 2001, SOU 2001:59. Stockholm: Fritzes, 209-238.
9.
Gutman L, Sameroff A, Cole R: Academic growth curve trajectories from 1st grade to 12th grade: effects of multiple social risk factors and preschool child factors. Dev Psychol. 2003, 39: 777-790.CrossRefPubMed
10.
Sirin SR: Socioeconomic status and academic achievement: a meta-analytic review of research. Rev Educ Res. 2005, 75: 417-453. 10.3102/00346543075003417.CrossRef
11.
Bradley RH, Corwyn RF: Socioeconomic status and child development. Annu Rev Psychol. 2002, 53: 371-399. 10.1146/annurev.psych.53.100901.135233.CrossRefPubMed
12.
Lee V, Burkam D: Inequality at the Starting Gate: Social Background Differences in Achievement as Children Begin School. 2002, Washington: Economic Policy Institute
13.
Currie J, Duncan T: Early test scores, school quality and SES: long run effects on wage and employment outcomes. Res Labor E. 2001, 20: 103-132.CrossRef
14.
Marmot M: The Status Syndrome. 2004, New York: Henry Holt
15.
Wardle J, Steptoe A: Socioeconomic differences in attitudes and beliefs about healthy lifestyles. J Epidemiol Community Health. 2003, 57: 440-443. 10.1136/jech.57.6.440.CrossRefPubMedPubMedCentral
16.
Dalgard OS, Mykletun A, Rognerud M, Johansen R, Zahl PH: Education, sense of mastery and mental health: results from a nationwide health monitoring study in Norway. BMC Psychiatry. 2007, 7: 20-10.1186/1471-244X-7-20.CrossRefPubMedPubMedCentral
17.
Kestilä L, Koskinen S, Martelin T, Rahkonen O, Pensola T, Aro H, Aromaa A: Determinants of health in early adulthood: what is the role of parental education, childhood adversities and own education?. Eur J Public Health. 2006, 16: 306-315.PubMed
18.
Der G, Batty GD, Deary IJ: The association between IQ in adolescence and a range of health outcomes at 40 in the 19979 US National Longitudinal Study of Youth. Intelligence. 2009, 3: 573-580.CrossRef
19.
McKenzie SK, Carter K, Blakely T, Collings S: The association of childhood socioeconomic position and psychological distress in adulthood: is it mediated by adult socioeconomic position?. Longit Life Course Stud. 2010, 1: 339-358.
20.
Fergusson DM, Woodward LJ, Horwod LJ: Risk factors and life processes associated with the onset of suicidal behaviour during adolescence and early adulthood. Psychol Med. 2000, 30: 23-39. 10.1017/S003329179900135X.CrossRefPubMed
21.
Jablonska B, Lindberg L, Lindblad F, Rasmussen F, Östberg V, Hjern A: School performance and hospital admissions due to self-inflicted injury: a Swedish national cohort study. Int J Epidemiol. 2009, 38: 1334-1341. 10.1093/ije/dyp236.CrossRefPubMed
22.
Björkenstam C, Weitoft GR, Hjern A, Nordström P, Hallqvist J, Ljung R: School grades, parental education and suicide-a national register-based cohort study. J Epidemiol Community Health. 2011, 65: 993-998. 10.1136/jech.2010.117226.CrossRefPubMed
23.
Andersson L, Allebeck P, Gustafsson JE, et al: Association of IQ scores and school achievement with suicide in a 40-year follow-up of a Swedish cohort. Acta Psychiatr Scand. 2008, 118: 99e105-CrossRef
24.
Gunnell D, Löfving S, Gustaffson JE, Allebeck P: School performance and risk of suicide in early adulthood: follow-up of two national cohorts of Swedish schoolchildren. J Affect Disord. 2011, 131: 104-112. 10.1016/j.jad.2011.01.002.CrossRefPubMed
25.
Lyons RA, Jones SJ, Deacon T, Heaven M: Socioeconomic variation in injury in children and older people: a population based study. Inj Prev. 2003, 9: 33-37. 10.1136/ip.9.1.33.CrossRefPubMedPubMedCentral
26.
Batty GD, Whitley E, Deary IJ, Gale CR, Tynelius P, Rasmussen F: Psychosis alters association between IQ and future risk of attempted suicide: cohort study of 1, 109, 475 Swedish men. BMJ. 2010, 340: c2506-10.1136/bmj.c2506.CrossRefPubMedPubMedCentral
27.
Schmidtke A, Bille-Brache U, DeLeo D, et al: Attempted suicide in Europe: rates, trends and sociodemographic characteristics of suicide attempters during the period 1989-1992. Results of the WHO/EURO Multicentre Study on Parasuicide. Acta Psychiatr Scand. 1996, 93: 327-338. 10.1111/j.1600-0447.1996.tb10656.x.CrossRefPubMed
28.
29.
30.
Dawson G, Ashman SB, Carver LJ: The role of early experience in shaping behavioral and brain development and its implications for social policy. Dev Psychopathol. 2000, 12: 695-712. 10.1017/S0954579400004089.CrossRefPubMed
31.
32.
Tomalski P, Johnson H: The effects of early adversity on the adult and developing brain. Curr Opin Psychiatry. 2010, 23: 233-238. 10.1097/YCO.0b013e3283387a8c.CrossRefPubMed
33.
Hack M, Breslau N, Weissman B, Aram D, Klein N, Borawski E: Effect of very low birth weight and subnormal head size on cognitive abilities at school age. N Engl J Med. 1991, 325: 231-237. 10.1056/NEJM199107253250403.CrossRefPubMed
34.
Stein A, Malmberg L-E, Sylva K, Barnes J, Leach P, the FCCC team: The influence of maternal depression, caregiving, and socioeconomic status in the post-natal year on children's language development. Child Care Health Dev. 2008, 34: 603-612. 10.1111/j.1365-2214.2008.00837.x.CrossRefPubMed
35.
Statistics Sweden: Barn, boendesegregation och skolresultat. Children, segregated housing and school results. 2007, Demografiska Rapporter (Demographic reports), 2-
36.
Gutman LM, Feinstein L: Children's Well-Being in Primary School: Pupil and School Effects. 2008, London: Centre for Research on the Wider Benefits of Learning Institute of Education
37.
Statistics Sweden: Utbildningsnivå efter indikator, socioekonomisk grupp och kön. Level of education by the indicator, socioeconomic group and gender. [http://​www.​ssd.​scb.​se]
38.
Guo G, Harris KM: The mechanisms mediating the effects of poverty on children's intellectual development. Demography. 2000, 37: 431-447. 10.1353/dem.2000.0005.CrossRefPubMed
39.
De Civita M, Pagani L, Vitaro F, Tremblay RE: The role of maternal educational aspirations in mediating the risk of income source on academic failure in children from persistently poor families. Child Youth Serv Rev. 2004, 26: 749-769. 10.1016/j.childyouth.2004.02.019.CrossRef
40.
Werfhorst HG, Hofstede S: Cultural capital or relative risk aversion? Two mechanisms for educational inequality compared. Br J Sociol. 2007, 58: 391-415. 10.1111/j.1468-4446.2007.00157.x.CrossRefPubMed
41.
Due P, Lynch J, Holstein B, Modvig J: Socioeconomic health inequalities among a nationally representative sample of Danish adolescents: the role of different types of social relations. J Epidemiol Community Health. 2003, 57: 692-698. 10.1136/jech.57.9.692.CrossRefPubMedPubMedCentral
42.
Turkheimer E, Haley A, Waldron M, D'Onofrio B, Gottesman II: Socioeconomic status modifies heritability of IQ in young children. Psychol Sci. 2003, 14: 623-628. 10.1046/j.0956-7976.2003.psci_1475.x.CrossRefPubMed
43.
Modin B, Ostberg V, Almquist Y: Childhood peer status and adult susceptibility to anxiety and depression. A 30-year hospital follow-up. J Abnorm Child Psychol. 2010, 39: 187-199.CrossRef
44.
Baumeister RF, Campbell JD, Krueger JI, Vohs KD: Does high self-esteem cause better performance, interpersonal success, happiness, or healthier lifestyles?. Psychol Sci Public Interest. 2003, 4: 1-44. 10.1111/1529-1006.01431.CrossRefPubMed
45.
Reynolds JR, Ross CE: Social stratification and health: education's benefit beyond economic status and social origins. Soc Probl. 1998, 45: 221-247. 10.1525/sp.1998.45.2.03x0167k.CrossRef
46.
Clevenpalm J, Karlsson A-S: Health On Equal Terms? Results from the 2006 Swedish National Public Health Survey. 2009, Public Health: Swedish National Institute of
47.
The Swedish National Agency for Education: Vad påverkar resultaten i svensk grundskola? Kunskapsöversikt om betydelsen av olika faktorer. Which factors affect the results of Swedish comprehensive school? An overview of the importance of different factors. 2009, Stockholm: Fritzes
48.
Baron RM, Kenny DA: The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986, 51: 1173-1182.CrossRefPubMed
49.
50.
Aiken LS, West SG: Multiple Regression: Testing and Interpreting Interactions. 1991, Newbury Park: Sage
Metadata
Title
A national cohort study of parental socioeconomic status and non-fatal suicidal behaviour-the mediating role of school performance
Authors
Beata Jablonska
Frank Lindblad
Viveca Östberg
Lene Lindberg
Finn Rasmussen
Anders Hjern
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2012
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-12-17

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