Parental education and adolescent health problems due to violence, self-harm and substance use: what is the role of parental health problems?

• Published in: Journal of epidemiology and community health (1979) 2019-03, Vol.73 (3), p.225-231
• Main Authors: Remes, Hanna, Moustgaard, Heta, Kestilä, Laura M, Martikainen, Pekka
• Format: Article
• Language: English
• Subjects: Adolescence; Adolescent; Adolescent Health; Adolescents; Aggression; Child; Childrens health; Education; Educational Status; Female; Finland; Health problems; Hospitalization - statistics & numerical data; Humans; Infant, Newborn; Male; Mental disorders; Offspring; Parents & parenting; Parents - education; Parents - psychology; Patient admissions; Research report; Risk Factors; Risk taking; Self destructive behavior; Self-Injurious Behavior - epidemiology; Self-Injurious Behavior - psychology; Self-injury; Social Class; Social Determinants of Health; Socioeconomic factors; Studies; Substance use; Substance-Related Disorders - epidemiology; Substance-Related Disorders - psychology; Survival; Teenagers; Violence; Violence - psychology; Violence - statistics & numerical data; Young adults
• ISSN: 0143-005X; 1470-2738; 1470-2738
• DOI: 10.1136/jech-2018-211316

BackgroundAdolescent health problems are more prevalent in families with low socioeconomic position, but few studies have assessed the role of parental health in this association. This study examines the extent to which parental health problems, particularly those related to high-risk health behaviour, might explain the association between parental education and adolescent health problems due to violence, self-harm and substance use.MethodsWe used longitudinal register data on a 20% representative sample of all families with children aged 0–14 years in 2000 in Finland with information on parental social background and parental and offspring health problems based on hospital discharge data. We estimated discrete-time survival models with the Karlson-Holm-Breen method on hospital admissions due to violence, self-harm and substance use among adolescents aged 13–19 years in 2001–2011 (n=145 404).ResultsHospital admissions were 2–3 times more common among offspring of basic educated parents than tertiary educated parents. Similar excess risks were observed among those with parental mental health problems and parental health problems due to violence, self-harm and substance use. The OR for offspring of basic educated parents was attenuated from OR 2.73 (95% CI 2.34 to 3.18) to OR 2.38 (2.04 to2.77) with adjustment for parental health problems, particularly those due to violence, self-harm and substance use. Having both low parental education and parental health problems showed simple cumulative effects.ConclusionsThe excess risks of hospital admissions due to violence, self-harm and substance use among adolescents with lower educated parents are largely independent of severe parental health problems.