title: Adverse childhood experiences and disability pension in early midlife: results from a Swedish National Cohort Study.
abstract: Few studies have examined the association between adverse childhood experiences (ACEs) and disability pension (DP). The current study aimed to investigate the relationship between different ACEs, cumulative ACEs, and DP, and the mediating role of school performance. We used a Swedish cohort of 522 880 individuals born between 1973 and 1978. ACEs included parental death, parental substance abuse and psychiatric disorder, substantial parental criminality, household public assistance, parental DP and child welfare intervention. Estimates of risk of DP in 2008 were calculated as odds ratios (OR) with 95% confidence intervals (CIs). A total of 2.3% (3.0% females, 1.7% males) received DP in 2008. All studied ACEs increased the odds for DP, particularly child welfare intervention and household public assistance. Cumulative ACEs increased the odds of DP in a graded manner. Females exposed to 4+ ACEs had a 4-fold odds (OR: 4.0, 95% CI 3.5-4.5) and males a 7-fold odds (OR: 7.1, 95% CI: 6.2-8.1). School performance mediated the ACEs-DP association. This study provides evidence that ACEs is associated with increased odds of DP, particularly when accumulated. The effects of ACEs should be taken into account when considering the determinants of DP, and when identifying high-risk populations.
authors.affiliation: Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden.|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.
authors.forename: Emma
authors.initials: E
authors.lastname: Björkenstam
authors.affiliation: Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden.|Clinical Epidemiology/Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Hjern
authors.affiliation: Department of Social Work, Stockholm University, Stockholm, Sweden.
authors.forename: Bo
authors.initials: B
authors.lastname: Vinnerljung
mesh_terms: D000328:Adult; D000069586:Adult Survivors of Child Adverse Events / Q000523:psychology / Q000706:statistics & numerical data*; D016241:Child of Impaired Parents / Q000706:statistics & numerical data; D006233:Persons with Disabilities / Q000523:psychology / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D010415:Pensions / Q000706:statistics & numerical data*; D012737:Sex Factors; D012946:Social Welfare / Q000706:statistics & numerical data