Anders Hjern

Karolinska Institutet | KI · Department of Medicine, Solna

Aim The aim of this study was to describe parental concerns about child health and behaviour and their sociodemographic predictors in 3‐year‐olds, in relation to the national guidelines of well‐baby clinics. Methods The study included parents of 33 526 children in Stockholm who had completed a questionnaire prior to a routine visit to a well‐baby...

Importance The 1980 and 1986 Swedish so-called speed premium policies aimed at protecting parents’ income-based parental leave benefits for birth intervals shorter than 24 and 30 months, respectively, but indirectly encouraged shorter birth spacing and childbearing at older ages, both risk factors for several perinatal health outcomes. Whether thos...

It is well-known that experiences of out-of-home care (OHC; foster-family care and residential care) are linked to criminal behavior. Less is known how criminal activity in the OHC population develops over the life course and to what extent such development is characterized by desistance or persistence. Using population-based longitudinal register...

BACKGROUND: Exposure to childhood out-of-home care (foster family and residential care) is associated with an increased risk of ill-health and disability in adulthood, but the risk for cardiovascular disease has not previously been studied longitudinally. METHODS: This was a national cohort study generated from linkage of a range of population-bas...

Background Family policies can influence parents’ fertility behaviors, with consequences for perinatal health. The 1980 and 1986 Swedish speed premium policies aimed to protect parents’ income-based parental leave benefits within birth intervals shorter than 24 and 30 months, respectively, but additionally encouraged shorter birth spacing and child...

Aims We examined the patterns of healthcare utilisation for drug use disorders (DUDs) and charges related to narcotics among young refugees in Norway considering the role of sex, country of origin and condition of arrival (accompanied versus unaccompanied minors). Methods Based on national registers, sex-stratified Cox regression models were used...

Aim: The aim of this study was to investigate whether the choice reforms in health care in Stockholm county in 2008 and 2013 changed the sociodemographic user patterns of outpatient health care services for children. Methods: The study used regional data on health care use linked to sociodemographic data from national registers in the total popu...

Background: Child health and development can be promoted by strengthening and supporting parents. Research on parental support programs based on positive psychology and a health-promoting approach aimed at all parents, and in particular parents of infants is limited. All Children in Focus (ACF) is a parental support program that has been evaluated...

Background: Individuals with a history of out-of-home care in childhood experience elevated rates of mortality from all-causes and suicide in adulthood but the relationship with chronic disease is unknown. We examined the association between out-of-home care and cardiovascular disease (CVD) in a large cohort study and, in the women, explored how ca...

Background To study the association of maternal age upon arrival and length of residence in Sweden with the 4-year caries increment in their children between ages 3 and 7 years in relation to the human development index (HDI) of the maternal country of origin. Method This registry-based cohort study included all children born in 2000–2003 who resi...

Background Due to the circumstances of their early lives, young refugees are at risk of experiencing adverse labour market and health outcomes. The post-settlement environment is thought to play a decisive role in determining how this vulnerability plays out. This study compared trends in labour market marginalisation in young refugees and their ma...

Background: To study the association of maternal age upon arrival and length of residence in Sweden with the 4-year caries increment in their children between ages 3 and 7 years in relation to the human development index (HDI) of the maternal country of origin. Method: This registry-based cohort study included all children born in 2000–2003 who res...

This publication is also accessible online: https://www.norden.org/no/publication/hvordan-gar-det-med-unge-flyktninger-i-norden-coming-age-exile-cage

There is growing evidence on the observed and expected consequences of climate change on population health worldwide. There is limited understanding of its consequences for child health inequalities, between and within countries. To examine these consequences and categorize the state of knowledge in this area, we conducted a review of reviews index...

Aim The aim of this study was to describe sociodemographic and family predictors for behavioural and emotional problems in pre-schoolers. Methods This was a cross-sectional study including 30 795 children in the Stockholm region whose parents had completed the Strength and Difficulties Questionnaire (SDQ) prior to a routine visit to a well-baby cl...

Background Previous Scandinavian studies have shown increased levels of psychiatric morbidity in young refugees and international adoptees with an origin outside Europe. This study investigated their risk of non-affective psychotic disorders (NAPD) and whether this risk is influenced by early childhood adversity, operationalised as age at adoption/...

Background Undocumented migrants face many hardships in their everyday life such as poor living conditions, discrimination, and lack of access to healthcare. Previous studies have demonstrated considerable health care needs for psychiatric disorders as well as physical diseases. The aim of this paper was to find out the main barriers that undocumen...

Objectives To demonstrate the challenges of interpreting cross-country comparisons of paediatric asthma hospital admission rates as an indicator of primary care quality. Methods We used hospital administrative data from >10 million children aged 6–15 years, resident in Austria, England, Finland, Iceland, Ontario (Canada), Sweden or Victoria (Austr...

Aims This study aimed at comparing several health outcomes in young adulthood among child refugees who settled in the different immigration and integration policy contexts of Denmark, Norway and Sweden. Methods The study population included refugees born between 1972 and 1997 who immigrated before the age of 18 and settled in the three Nordic coun...

Refugee children in the Nordic countries have been reported to perform poorly in school and carry a high burden of familial posttraumatic stress. The present study aimed to investigate the impact of maternal and paternal posttraumatic stress on the school performance of refugee children. We used national register data on school grades at age 15–16...

Parental psychiatric morbidity related to experiences of war and trauma has been associated with adverse psychological outcomes for children. The aim of this study was to investigate parental post-traumatic stress in relation to psychiatric care utilization among children of refugees with particular attention on the child’s own refugee status, sex...

This study investigated mental health in schoolchildren in different living arrangements after parental separation. The study population included 31,519 children from the Danish National Birth Cohort, followed-up at age 11 in 2010–2014. Child mental health was measured with a maternal report of the Strength and Difficulties Questionnaire (SDQ). Ass...

Introduction Sweden has long been praised for a generous parental leave policy oriented towards facilitating a gender-equitable approach to work and parenting. Yet certain aspects of Swedish parental leave could also be responsible for the maintenance of (or even the increase in) health inequalities. Using a ‘Health in All Policies’ lens, this rese...

Aim This study compared mental health after parental separation in seven‐year‐old children living in joint physical custody with sole physical custody family arrangements. Methods The study population included 39,661 children from the Danish National Birth Cohort, living in a nuclear family at age six months. Child mental health was measured at ag...

Background In the context of containment measures against the COVID-19 pandemic, the aims were to examine the impact of lockdown and school closures on childs’ and adolescents’ health and well-being and social inequalities in health. Methods Literature review by searching five databases until November 2020. We included quantitative peer-reviewed s...

Background Parental separation has been associated with adverse child mental health outcomes in the literature. For school-aged children, joint physical custody (JPC), that is, spending equal time in both parents’ homes after a divorce, has been associated with better health and well-being than single care arrangements. Preschool children’s well-be...

Purpose Early identification of persons at risk is essential in suicide prevention. Undocumented migrants (UM) live under limited conditions and are to a high degree invisible, both in research and in suicide prevention programmes. The aim of this study was to investigate prevalence rates of suicidal thoughts among UM in Sweden. Design/methodology...

Aim To study the association of parental country of origin – expressed as low‐, medium‐, and high Human Development Index (HDI) countries ‐ with caries experience in children of immigrant families in Stockholm. Methods This registry‐based cohort study included all children born in 2000–2003 who resided in Stockholm County, Sweden, at age 3 years (...

This study aims to examine whether disparities in gestational age outcomes between foreign and Swedish-born mothers are contingent on the measure used to estimate gestational age and, if so, to identify which maternal factors are associated with the discrepancy. Using population register data, we studied all singleton live births in Sweden from 199...

This is the final report of the CAGE-project.

Background Non-European international adoptees in Sweden were shown to have a three-to fourfold higher risk of suicidal behaviour in youth during 1986–1995 compared with the general population. The aim of this study was to investigate whether this high risk persists beyond youth and in later cohorts. Methods A register study of Swedish national co...

Today, there is limited knowledge about the living conditions of undocumented migrants (UMs) in Sweden. It is hypothesised that Ums’ living conditions increases cases of mental illness among them. The aim of this study was twofold, to explore: the housing situation of UMs in Sweden, and its association to their state of mental health. A cross‐secti...

Background This study explored how inequality in labour market marginalisation (LMM) between refugees and their peers developed during early adulthood in Denmark and Sweden (DK/SE), and the role of common mental disorders (CMD) in these trends. Methods Using registry data, all refugees living in DK/SE in 2009-2012 who were born 1986-1993 and who i...

Introduction: Although ethnically mixed couples are on the rise in industrialized countries, their health behaviors are poorly understood. We examined the associations between partner's birthplace, age at immigration and smoking during pregnancy among foreign-born women. Methods: Population-based register study including all pregnancies resultin...

Aim Refugee children have been shown to underutilise psychiatric services in Scandinavia. The aim of this study was to investigate determinants of psychiatric care utilisation in adolescents in refugee families. Methods The study used regional data on health care use linked to sociodemographic data from national registers in a total population of...

Background: International guidelines in 2008 recommended orchidopexy for undescended testis at 6-12 months of age to reduce the risk of testicular cancer and infertility. Using administrative data from England, Finland, Ontario (Canada), Scotland and Sweden (with data from Victoria (Australia) and Iceland in supplementary analyses), the aim of thi...

Background: To analyse the impact of austerity measures taken by European governments as a response to the 2008 economic and financial crisis on social determinants on child health (SDCH), and child health outcomes (CHO). Methods: A systematic literature review was carried out in Medline (Ovid), Embase, Web of Science, PsycInfo, and Sociological...

Background: Fathers may affect expectant mothers' daily living situations, which in turn might influence pregnancy outcomes. We investigated the association between paternal violent criminality and risk of preterm birth (≤36 weeks). Methods: We conducted a register-based study with all live singleton births in the Swedish Medical Birth Register...

Objective: To determine the association between maternal age at delivery and caries in offspring. Materials and methods: This registry-based cohort study included all children born between 2000 and 2003 and who were residing in Stockholm County, Sweden, at 7 years of age. Between 2007 and 2010, the cohort (n = 65,259) was examined to determine cari...

Background Young maternal age is associated with lower birthweight and higher rates of preterm birth and childhood hospitalisations. Internationally, teen pregnancy rates vary widely, reflecting differences in social, welfare, and health care factors in different cultural contexts. Objectives To determine whether the increased risk of adverse infa...

Aim Parental separation has been associated with poor mental health in children. with better outcomes in children living in joint physical custody compared to those living with one parent after the separation. In this study we investigated socioeconomic and relational predictors in early childhood of later parental separation and family arrangement...

Objectives : To analyse the impact of austerity measures taken by European governments as a response to the 2008 economic and financial crisis on social determinants and child health (SDCH), and child health outcomes (CHO). Methods : A systematic literature review was carried out in Medline (Ovid), Embase, Web of Science, PsycInfo, and Sociologica...

Objectives : To analyse the impact of austerity measures taken by European governments as a response to the 2008 economic and financial crisis on social determinants and child health (SDCH), and child health outcomes (CHO). Methods : A systematic literature review was carried out in Medline (Ovid), Embase, Web of Science, PsycInfo, and Sociologica...

Background: To analyse the impact of austerity measures taken by European governments as a response to the 2008 economic and financial crisis on social determinants on child health (SDCH), and child health outcomes (CHO). Methods: A systematic literature review was carried out in Medline (Ovid), Embase, Web of Science, PsycInfo, and Sociological a...

Aim: The aim of this review was to evaluate the evidence for interventions for infantile colic. Methods: This was a systematic review based on a literature search in December 2017 for articles published during 2007-2017 about preventive and treatment interventions for infantile colic in infants. The review included original randomised controlled...

Background: Birth order has been shown to affect the health of the child; less is known, however, about how birth order affects caries development in children. Thus, the present study investigated the association between birth order and dental caries development in young children. Methods: This retrospective registry-based cohort study included...

Aim: The aim of this narrative review was to evaluate the evidence for interventions for children's secure attachment relationships and parents' caregiving sensitivity that could potentially be implemented in the context of a well-baby clinic. Methods: Literature search on programmes for parental caregiving sensitivity and secure attachment for...

Background: Since birth outcome is associated with maternal and newborn health, it can be a predictor of the future health of the child. Aim: To investigate the association between adverse birth outcomes and dental caries. Design: The present registry-based cohort study included all children born in 2000-2003, residing in Stockholm County, Swe...

Aim: The aim of this review was to evaluate the evidence for interventions for behavioural sleep problem in infants. Methods: Systematic review based on a search in MEDLINE, Web of Science and PsychINFO in December 2017 for articles published in English during 2007-2017 about preventive and treatment interventions for sleep problems in infants....

When a child is removed from their home and placed in foster care, society takes over the responsibility for that child’s well-being and development. Failure to provide a child with a nurturing upbringing may have negative consequences for the child as well as for society. Using Swedish longitudinal registry data for a national cohort sample of sib...

Background: Birth order has been shown to affect the health of the child; less is known, however, about how birth order affects caries development in children. Thus, the present study investigated the association between birth order and dental caries development in young children. Methods: This retrospective registry-based cohort study included all...

Parental education is a robust predictor of children's educational outcomes in general population studies, yet little is known about the intergenerational transmission of educational outcomes in alternative family settings such as children growing up in foster care. Using Swedish longitudinal register data on 2,167 children with experience of long-...

Background: Birth order has been shown to affect the health of the child; less is known, however, about how birth order affects caries development in children. Thus, the present study investigated the association between birth order and dental caries development in young children. Methods: This retrospective registry-based cohort study included all...

Studies have found that sibling loss is associated with an increased risk of death from external causes (i.e. suicides, accidents and homicides). Increased psychiatric health problems following bereavement could underlie such an association. We studied the influence of sibling loss during childhood on psychiatric care in young adulthood, adjusting...

Background Birth order has been shown to affect the health of the child; less is known, however, about how birth order affects caries development in children. Thus, the present study investigated the association between birth order and dental caries development in young children. Methods This retrospective registry-based cohort study included all c...

Most European countries have systematic health assessments of refugees with a main focus on infectious diseases. The aim of this study was to describe the broader health care needs identified in newly settled refugee children in a school health setting. The study population consisted of all 609 recently settled Non-European refugee and asylum-seeki...

In this issue of Acta Paediatrica, Paradella et al 1 report the findings of a Danish study that noted that undocumented migrant children presented with diverse health needs and sometimes had critical health conditions. This paper raises important questions about access to health care for migrant children in Europe who are not legal residents. As me...

Background: Birth order has been shown to affect the health of the child; less is known, however, about how birth order affects caries development in children. Thus, the present study investigated the association between birth order and dental caries development in young children. Methods: This retrospective registry-based cohort study included all...

Aim: Decades of research confirm that children and adolescents in out-of-home care (foster family, residential care) have much greater healthcare needs than their peers. A systematic literature review was conducted to evaluate organizational healthcare models for this vulnerable group. Methods: A systematic literature search was undertaken of th...

We examined whether women experiencing severe maternal morbidity (SMM) are more likely to be treated for a psychiatric illness or be prescribed psychotropic medications in the postpartum year than mothers who did not experience SMM. We also examine the relationship between SMM and specific mental health-related outcomes, and the relationship betwee...

Childhood parental death has been associated with adverse health, social and educational outcomes. Studies on long-term outcomes are in general scarce and there is little evidence on the long-term impact on antisocial behaviour. This study takes advantage of high-quality register data to investigate risk of violent crime in relation to childhood pa...

Background: An increasing number of migrants have fled armed conflict, persecution and deteriorating living conditions, many of whom have also endured risky migration journeys to reach Europe. Despite this, little is known about the perinatal health of migrant women who are particularly vulnerable, such as refugees, asylum-seekers, and undocumente...

Objective To compare mortality in children aged <5 years from two causes amenable to healthcare prevention in England and Sweden: respiratory tract infection (RTI) and sudden unexpected death in infancy (SUDI). Design Birth cohort study using linked administrative health databases from England and Sweden. Setting and participants Singleton live b...

Sehr viele schwedische Kinder leben in Doppelresidenz. Der Beitrag reflektiert die Hintergründe für die große Verbreitung anteiliger Kinderbetreuung durch schwedische Eltern nach einer Trennung und präsentiert die Forschungsergebnisse zu den Auswirkungen dieses Lebensmodells auf die Gesundheit und das Wohlbefinden der Kinder.

Background: Childhood adversity (CA) is a risk indicator for psychiatric morbidity. Although CA has been linked to violent offending, limited research has considered adolescent psychiatric disorder as a mediating factor. The current study examined whether adolescent psychiatric disorder mediates the association between CA and violent offending. M...

Aim: Posttraumatic stress disorder (PTSD) in parents can have severe consequences also for their children. Prevalence of PTSD is high among refugees. Refugee children have been reported to perform poorly in school. The aim of this study was to investigate the impact of PTSD in refugee and native Swedish parents on children’s school performance and...

Background: Measles has made a comeback in Western Europe, with more cases being reported each year. One factor behind this development is low vaccination coverage in socially disadvantaged segments of the population in many countries. This study investigates whether socioeconomic patterns of uptake of the measles, mumps and rubella (MMR) vaccine...

A growing corpus of evidence reveals that smoking patterns of migrant women tend to converge with that of the host population over time ('acculturation paradox'). In this paper we aim to adopt a health equity perspective by studying the extent to which this pattern reflects a convergence with the group of natives who are more socioeconomically disa...

Joint physical custody (JPC) refers to a practice where children with separated parents share their time between the parents’ respective homes. Studies on parents’ views of JPC for young children are scarce. The aim of this interview study was to explore parents’ perceptions on how they experience and practice equally shared JPC for their 1–4 year-...

De-identified interview excerpts. (DOCX)