Economic poverty among children and adolescents in the Nordic countries

Self-reported and parent-reported mental health in children from low-income families in Agder, Norway: results from baseline measurements of New Patterns project participants

BACKGROUND

Poverty may pose risks to child and adolescent mental health, but few studies have reported on this association among children and adolescents in low-income families in Norway.

METHODS

Based on a sample participating in an intervention for low-income families in Norway, we report data from the survey administered at the start of the intervention. Mental health problems were measured using the Strengths and Difficulties Questionnaire (SDQ; self-report (SR) n = 148; parent/proxy-report (PR) n = 153, mean age = 10.8). Demographic and family characteristics were obtained from parent reported data. Results are presented by gender and migration background. Regression analysis was used to investigate the relative contribution of background factors to mental health symptoms. The distribution of scores is compared to UK norms.

RESULTS

Participants reported relatively high scores on the Strengths and Difficulties Questionnaire (SDQ) Total Difficulties Scale (parent/proxy-report, PR mean=10.7; self-report, SR mean=10.1). Participants with non-immigrant backgrounds scored considerably higher on the Total Difficulties Scale (PR mean difference=2.9; SR 5.3) and on most other domains measured with the SDQ compared with their peers with immigration backgrounds. Participants generally scored higher than or equal to UK norms.

CONCLUSION

Participants in the current study had many symptoms of mental health problems, with large differences between those with and without a migrant background. Interventions for low-income families should be based on detailed knowledge about differences in family risks, resources and needs.

Problematic parental substance use, childhood family structures and adverse outcomes in young adulthood

Aim: The aim of the present study was to investigate the association between childhood family structures, including the presence or absence of problematic parental substance use (PPSU), and adverse outcomes during adolescence/young adulthood. Methods: The study population included 9,770 young people (aged 15-25 years) from samples drawn for two national surveys in Denmark during 2014-2015. By combining surveys with national register data, five types of childhood family structures were constructed based on whether the child experienced PPSU and/or family separation and the number of years the child lived with a parent with substance use problems. Using binary logistic regression models, the relationships between family structure and adverse outcomes in young adulthood (i.e., hospital admissions, mental disorders and criminality) were investigated. Results: Young people who experienced PPSU and did not live with both parents had higher odds of the different long-term adverse outcomes compared with young people who did not experience PPSU, and similar odds of the outcomes compared to youth who had not experienced PPSU and did not live with both parents. The highest odds of adverse outcomes were found among young people who experienced PPSU and lived with the parent with substance use problems for less than five years. Conclusions: Living with both parents protected against adverse outcomes in young adulthood, and if PPSU was present, the odds of adverse outcomes increased. The hypothesis that there would be a positive association between years living with a parent with substance use problems and adverse outcomes in young adulthood was not supported. Awareness should be raised in health service, educational and legal institutions about the risk for young people from families with PPSU who do not live with both parents.

Norwegian policies to reduce social inequalities in health: Developments from 1987 to 2021

Reducing social inequalities in health has been an important aim in the development of the Nordic welfare states. This Commentary presents the development of Norwegian policies in this area from 1987 to 2021. Social inequalities entered the political agenda in Norway in the 1980s, but were mostly defined as a problem for selected marginalised groups. The World Health Organization project led by Michael Marmot was an inspiration for Norwegian policy-makers and the concept of the social gradient was introduced. From 2005, levelling the social gradient in health became a central strategy in Norwegian policy-making and culminated in the Public Health Act 2012. This Act focuses on the structural determinants of health and the municipalities have a central role in its implementation. However, the municipalities are mostly responsible for services providing downstream measures and have little control over social determinants such as tax or labour market policies. The Public Health Act is important because it institutionalises social inequalities as a policy field within public health. Not only the municipalities, but all administrative levels have to contribute to meet the aim of reducing the social gradient.

Are universal measures sufficient in reducing child poverty in the Nordic countries? An analysis of policies and political commitments

BACKGROUND

The five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) have long traditions of social welfare policies that have eradicated poverty as part of their goals. The purpose of this study was to increase our understanding of why child poverty is still significant in the Nordic countries despite existing strategies.

METHODS

A qualitative analysis of Nordic government documents and reports between 2007 and 2019 was carried out to track changes in public health priorities and political measures and to determine the similarities and differences between the five countries.

RESULTS

In all countries, most of the measures were universal, such as benefits during pregnancy, paid parental leave before and after the child was born, paid parental leave related to children's sickness, child allowances, day care, free health care for children and support for disabled children. National policies aimed to reduce social inequalities and child poverty exist in all five countries, but unaffordable housing, unequal disposable family income distribution and unequal income distribution at local municipality levels seem to be obstacles to reaching national policy goals.

CONCLUSIONS

Despite comprehensive universal measures to eradicate child poverty, inequalities are significant and increasing in some of the Nordic countries. This might be due to a lack of proportional universalism, where universal measures are in place in all Nordic countries, but with a lack of scale and intensity proportional to the children and families at risk. The significance of eliminating social inequalities needs to be emphasised at the local level.

Policies to Reduce Child Poverty in Norway: Can Municipalities Ensure Positive Functionings for Children through Housing Policies?

Child poverty is an increasing challenge for Norwegian society and its municipalities. Policies to reduce it include housing as one particularly important health determinant. The capability approach allows us to focus on determinants for health. Methods were triangulated and literature and document studies, interviews and participating observations were part of the data-gathering process. Thematic analyses were used to analyse data. Children and adults view housing as important. Housing determines families’ possibilities of consuming other goods and choosing what functionings they will convert their resources into. Municipalities can change the course of development by engaging with the Norwegian Government Housing Bank and implementing instruments such as social housing, housing allowances and starter loans giving families the possibility to become homeowners. Housing determines intra- as well as inter-generational life chances. Housing is a corrosive functioning if children live in families that have low-quality housing or high housing costs. Housing is a positive functioning for children if families own their housing. Housing is defined as a market good and a welfare asset. Policies enable some families to buy their own housing, whereas the number of poor children still increases.

Experiences of family violence and parental unavailability in childhood in relation to parental socioeconomic position and psychological problems: a cohort study of young Swedish women 1990-2013

Background

Despite the high prevalence and severe consequences for health and wellbeing, epidemiological research of neglected emotional needs during childhood is scarce and little is known about its relation to parental socioeconomic position (SEP). This study investigates the prevalence of family violence and parental unavailability in childhood and its association with parental SEP and parental psychological problems in four strata of young Swedish women examined 1990, 1995, 2000, and 2013.

Method

The sample comprised 976 women (mean age 22, range 20–25) living in Sweden. Secular trends for family violence, parental rejection and unavailability were analyzed using logistic regression as a function of year of examination. The associations with parental SEP and parental psychological problems were assessed using logistic regression with results in terms of odds ratios (OR) and 95% confidence intervals.

Results

Gendered patterns were observed in the associations between parental psychological problems and family violence and parental unavailability. Maternal psychological problems were associated with maternal rejection OR 6.8 (3.5–13.0), maternal lack of time OR 2.4 (1.2–5.0), and paternal rejection OR 1.9 (1.1–3.5). Paternal psychological problems were associated with paternal rejection OR 4.0 (2.1–7.7), paternal lack of time OR 4.9 (2.3–10.6), and experiencing family violence OR 4.9 (2.1–11.6). Low and medium parental SEP were associated with experience of family violence in childhood OR 3.1 (CI 1.1–8.5) and OR 3.4 (1.7–6.9), respectively. No changes between 1990 and 2013 were observed for the prevalence of any of the outcomes.

Conclusions

A stable prevalence of family violence and parental unavailability was reported by young women examined between 1990 and 2013. Lower socioeconomic position was associated with family violence while the association with parental unavailability was non-significant. Gendered patterns were observed in the association between parental psychological problems and family violence, where paternal but not maternal psychological problems were associated with family violence. Further, maternal psychological problems were associated with paternal rejection while paternal psychological problems were not associated with maternal rejection. Gendered patterns of parental unavailability need further studies.