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Background: Rising rates of internalizing disorders and rising rates of school failure among adolescents are growing concerns. Despite the strong association between academic achievement and internalizing disorders, possible links between these two trends have not been investigated. Thus, the aim of this study was to investigate the development of the cross-sectional associations between academic achievement and internalizing disorders in Swedish students aged 16 years between 1990 and 2018.

Methods: Register data on specialist psychiatric care and prescriptions of psycholeptic and psychotropic drugs were linked to data on students’ school grades in the last year of compulsory school. The total sample size was 3,089,674 students. Logistic regression models with internalizing disorders as the dependent variable, and graduation year and academic achievement as independent variables, were estimated.

Results: Throughout the period, there was a strong negative association between academic achievement and internalizing disorders. Low-achieving students had by far the highest risks of internalizing disorders. In absolute terms, the increase in internalizing disorders was clearly largest for low-achieving students. The relative risks for low-achieving compared to higher achieving students increased between 1990 and 2010 and declined after 2010.

Conclusions: This study found consistently large, and at least until 2010 growing, achievement-related inequalities in internalizing disorders among Swedish adolescents between 1990 and 2018, with the lowest achieving students having disproportionally high risks. The increasingly pronounced concentration of internalizing disorders in the lowest rungs of the achievement distribution suggests that preventive interventions should focus on supporting this doubly disadvantaged group of students.

Aims: To examine associations between multiple clinically diagnosed mental disorders among children in Sweden and educational achievements at the end of ninth grade.

Methods: Data from Swedish administrative registers were utilised. Diagnoses of specific mental disorders (unipolar depression, mood, anxiety, obsessive compulsive, eating, attention deficit hyperactivity disorder) were used as exposure variables. Educational achievements were assessed in terms of teacher-assigned school grades and eligibility for upper secondary education. The sample comprised 266,664 individuals (49% females) born in 2000 to 2002 who were alive and resident in Sweden in 2017. Exposed and unexposed individuals were compared in terms of outcome variables by fitting linear and logistic regression models.

Results: The results revealed negative associations between all the examined mental disorders and educational achievements, except for positive associations between eating disorders and grades among female students. Attention deficit hyperactivity disorder was the most strongly associated disorder in terms of non-successful completion of compulsory education, among both male and female students (odds ratio (OR): 3.58 (95% confidence interval (CI), 3.42 to 3.74) and 4.31 (95% CI, 4.07 to 4.57), respectively). This was followed by unipolar depression among males (OR: 2.92 (95% CI, 2.60 to 3.28)) and anxiety disorder among females (OR: 2.68 (95% CI, 2.49 to 2.88)). Obsessive compulsive disorder had the weakest negative association with educational achievements among both males (OR: 1.48 (95% CI, 1.01 to 2.17)) and females (OR: 1.38 (95% CI, 1.11 to 1.72)).

Conclusions: Specific diagnosed mental disorders have varying, largely disadvantageous, associations with educational achievements of students in Sweden that differ between males and females.

Teenage parenthood is thought to have long term consequences for the life trajectory of young parents, with the responsibilities of small children restricting the time available to parents to invest in education and establish social networks at this crucial life course stage. It also results in normative tensions, with childbearing happening “out of order” with respect to other keymarkers of the transition to adulthood. In this study, we take a multi-dimensional approach to the idea of the labor market consequences of teenage parenthood, following young men and women across their first decade on the labor market in Sweden, to investigate if becoming a teenage parent is associated with different and more disadvantaged labor market pathways than for their siblings. Using sequence analysis and sibling models with Swedish register data, our results illustrate that while most teenage parents follow labor market trajectories that are not characterized by entrenched disadvantage, teenage parenthood represents an increased risk of disruption of the labor market career, mainly by delaying the entry of employment linked to decent earnings. The difficulties faced upon early childbearing are even more evident among women, who face much higher risk of entrenched patterns of sustained low wage employment or patterns of long-term labor market exclusion. 

In this paper, we address the questions of whether early family trajectories of parents are reflected in childbearing teenagers, and how socio-economic and family background factors impact these intergenerational correlations. We use within-dyad sequence analysis to examine combined marital and childbearing trajectories, up to age 30, of two generations of a representative sample of childbearing teenagers born between 1975 and 1985 and their progenitors, drawn from the Swedish population register data. We find evidence for within-family persistence of early family trajectories, with better matches across family state sequences for dyads composed of childbearing teenagers and their parents, than for dyads composed of childbearing teenagers and parents of random birth cohort peers. Regression analysis shows that these intergenerational associations are stronger and occur among later-born siblings from non-traditional family backgrounds, and among families with lower socio-economic backgrounds. This study fills gaps in the knowledge of intergenerational family life course dynamics beyond the early parenthood event.

Background: While previous research has evidently and extensively acknowledged socioeconomic gradients in children's education, we know very little about the determinants of socioeconomic-related inequality in children's education at the population level in Sweden. Therefore, we aimed: (i) to assess the extent of income inequality in upper secondary school completion in Sweden; (ii) to examine the contribution of mental health and other determinants to income inequality; and (iii) to explore gender differences in the magnitude and determinants of the inequalities.

Method: We utilised data from a population-based cohort available in Umeå SIMSAM Lab, linked with several national registries in Sweden. The dataset includes all children who were born in Sweden in 1991 and completed or not completed their upper secondary education in 2010, n = 116,812 (56,612 girls and 60,200 boys). We analysed the data using a Wagstaff-type decomposition method.

Results: The results first show substantial income-related inequality in upper secondary school incompletion concentrated among the poor in the Swedish setting. Second, these inequalities were in turn to a large degree explained jointly by parental, family and child factors; primarily parents' income and education, number of siblings and child's poor mental health. Third, these inferences remained when boys and girls were considered separately, although the determinants explained a greater share of the inequalities in boys than in girls.

Conclusion: Our results highlighted substantial income-related inequality in upper secondary school incompletion concentrated among the poor in the Swedish setting. Apart from family level characteristics, which explained a large portion of the inequalities, mental health problems appeared to be of particular importance as they represent a central target for both increasing the population average in upper secondary school completion and for reducing the gap in income-related inequalities in Sweden.

Previous research has focused on teenage parenthood as a single outcome, and has overlooked the wider family formation trajectory in which it is situated. In this paper, using Swedish register data and sequence analysis tools, we explore the diversity in timing and ordering of childbearing and (re)partnering events among teenage parents. We identify trajectory clusters of traditional family patterns, modern family patterns, single parenthood and re-partnering patterns. We also examine the role of resources in the family of origin for the probability of following the different types of family formation trajectories among teenage parents. Where economic resources in the family of origin is related to the type of trajectory teenage fathers follow, family structure is of greater importance for teenage mothers. The family formation trajectories of teenage parents display substantial heterogeneity, which contradicts a view that a person who has a child early in life suddenly has their life's script written.

The purpose of the present study was to investigate the effects of parental health problems on the probability of youths leaving upper secondary education before completion in Sweden, and to investigate potential gender differences in these effects. Medical and social microdata from Swedish administrative registers were used. The study population consisted of individuals born between 1987 and 1990 (N = 398,748) who were still alive and residing in Sweden in 2010. We employed a quasi-experimental pre-test post-test study design. Logistic regression was used to analyse the relationships between indicators of parental illness and young people's early school leaving in relation to health and sociodemographic confounders. Having had a mother or father with psychiatric, but not somatic, illness that necessitated hospitalisation after completing compulsory schooling was significantly associated with an increased probability of leaving upper secondary education. We found no significant gender-specific interaction effects. The existence of these effects in Sweden, a country with an extensive institutional welfare system, suggests that similar but more pronounced effects may exist in regions lacking such systems.

BACKGROUND: The presence of health problems in a child is known to be negatively associated with later academic achievement, but less is known about the educational outcomes for siblings of children in poor health. The study investigated how having a sibling with health problems affects a healthy sibling’s academic achievement.

METHODS: We utilized medical and social microdata from Swedish administrative population registers. Our sample consisted of N = 115 106 individuals (51.3% boys) born in 1990 in Sweden. We compared children with ill siblings to children whose siblings did not have poor health. Siblings’ hospital admissions and the academic achievements of the healthy sibling during their final year of compulsory education (at the age of 15-16) were analyzed using linear and logistic regression in relation to individual health- and family-related confounders.

RESULTS: Sibling hospitalization was significantly associated with lower overall grade points (b = –10.73, p < .001) and an increased odds ratio (OR) of ineligibility for upper secondary education (OR = 1.42, 95% CI = 1.31-1.52, p < .001).

CONCLUSIONS: School and health personnel should also consider the needs of healthy siblings during their work with children in poor health, because they too can be disadvantaged.

This study investigates why the relationship between health problems requiring hospitalization between the ages of 13 and 16 and school achievement (school grades in 9th grade) in Sweden was stronger for girls than for boys. We reviewed previous research on gender differences in subjective health, health care utilization and medical drug treatment to identify mechanisms responsible for this gendered effect. The relationship was analysed using retrospective observational data from several national full-population registers of individuals born in 1990 in Sweden (n = 115 196), and ordinary least squares techniques were used to test hypotheses. We found that girls had longer stays when hospitalized, which mediated 15% of the interaction effect. Variability in drug treatment between boys and girls did not explain the gendered effect of hospitalization. The main mediator of the gendered effect was instead differences in diagnoses between boys and girls. Girls’ hospitalizations were more commonly related to mental and behavioural diagnoses, which have particularly detrimental effects on school achievement.

Background: Coeliac disease might affect school performance due to its effect on cognitive performance and related health consequences that might increase school absenteeism. The aim of this study was to investigate whether children with coeliac disease performed differently on completion of ninth grade in school compared with children without coeliac disease.

Methods: Analysis was performed on a population of 445 669 children born in Sweden between 1991 and 1994 of whom 1767 were diagnosed with coeliac disease. School performance at ninth grade was the outcome and coeliac disease was the exposure. Other covariates included sex, Apgar score at 5 min, small for gestational age, year of birth, family type, parental education and income.

Results: There was no association between coeliac disease and school performance at ninth grade (adjusted coefficient -2.4, 95% CI 5.1 to 0.4). A weak association was established between late coeliac diagnosis and higher grades, but this disappeared after adjusting for parent socioeconomic conditions. Being small for gestational age affected performance negatively (adjusted coefficient -6.9, 95% CI 8.0 to 5.7). Grade scores were significantly lower in children living with a single parent (adjusted coefficient -20.6, 95% CI 20.9 to 20.2), compared with those with married/cohabiting parents. A positive association was found between scores at ninth grade and parental education and income.

Conclusion: Coeliac disease diagnosis during childhood is not associated with poor school performance at ninth grade.