Childhood adversity and risk of later labor market marginalization in young employees in Sweden

Author:

Björkenstam Emma123ORCID,Helgesson Magnus1ORCID,Mittendorfer-Rutz Ellenor1

Affiliation:

1. Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet , Stockholm, Sweden

2. Department of Community Health Sciences, Fielding School of Public Health and California Center for Population Research, University of California Los Angeles , Los Angeles, CA, USA

3. Department of Medical Sciences, Psychiatry, Uppsala University , Uppsala, Sweden

Abstract

AbstractBackgroundThe present study examined the independent and combined effects of childhood adversity (CA) and occupational class on the risk of future labor market marginalization (LMM) in young employees in Sweden. Occupational class (non-manual/manual workers) was also explored as a potential mediator.MethodsThis population-based longitudinal cohort study included 556 793 employees, 19–29 years, residing in Sweden in 2009. CAs included parental death, parental mental and somatic disorders, parental separation, household public assistance, single-parent household and residential instability. Measures of LMM included long-term unemployment (LTU), long-term sickness absence (LTSA) and disability pension. Estimates of risk of each LMM measure, between 2010 and 2016 were calculated as hazard ratios (HRs) with 95% confidence intervals (CIs), using a Cox regression analysis.ResultsThose exposed to CA had an elevated risk for all measures of LMM. Manual workers with a history of household public assistance had the highest risk estimates compared to non-manual workers with no CAs [adjusted HR spanning from 1.59 (LTSA) to 2.50 (LTU)]. Regardless of occupational class, the risk of LMM grew higher with increasing number of CAs (e.g. adjusted HR of LMM in manual workers with 3+ CAs: 1.87, 95% CI: 1.81–1.94). These patterns persisted after adjustments for a range of confounders, including psychiatric and somatic morbidity. Last, we found a small but significant mediating effect of occupational class in the association between CA and LMM.ConclusionsInformation on CAs are important determinants of LMM in young adults, and especially in manual workers.

Funder

AFA Insurance

Publisher

Oxford University Press (OUP)

Subject

Public Health, Environmental and Occupational Health

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