Health and social outcomes among children in low-income families and families receiving social assistance--A Swedish national cohort study

We examined health and social outcomes among children related to parental disposable income and receipt of social assistance. Swedish national registry data were used in a longitudinal design. We estimated relative risks and odds ratios for health and social outcomes in Poisson and logistic regressions among 1.2 million children between 1993 and 2002, and adjusted for factors that might affect the associations. Children in families receiving long-term social assistance showed considerably less satisfactory future prospects regarding health-related outcomes--all-cause mortality, suicide attempt, alcohol and drug misuse. Also, and to an even greater extent, the children experienced low educational attainment and social assistance in young adulthood compared with the rest of the population, and also in comparison with other low-income families. Low income was also associated with risk increases, but to a lesser extent. After taking into account the greater proportion of social-assistance recipients in low-income groups, attenuated risk increases remained only regarding future prospects of low education and social assistance. Regarding both low income and months receiving social assistance there was a gradient, at least in the age-adjusted analyses; there were greater risk increases among long-term recipients and among those with low incomes, and lower risk increases among short-term recipients and among those with high incomes. The results indicate that growing up in a family on long-term social assistance is a robust risk marker for compromised long-term development. A policy whereby children and parents receiving long-term assistance are offered access to evidence-based prevention programs in the areas of health, education and skills training appears to be important.