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Aim: Our aim in this paper was to estimate the contribution of different parental specialised health care diagnoses to the subsequent risk of entry into the social assistance system for families with children in the period 1998–2013. Methods: We used longitudinal population-level register data consisting of all children born in 1997 in Finland and their registered parents (54 960 one and two-parent families with 801 336 observations in the period 1998–2013). Diagnoses assigned in public specialised healthcare and social assistance records were derived from nationwide administrative registers. Measures of parental socioeconomic status and previous diagnoses and the birth weight of the child were adjusted for in regression models which estimated the association between parental diagnoses and entry into the social assistance system in the following year. Results: Families with a parent somatic diagnosis had a risk ratio of 1.4 for social assistance entry in the subsequent year of the diagnosis though substantial variation by diagnosis category was detected. Parent psychiatric diagnoses were linked to a higher, 3.01-fold risk of social assistance entry. Covariate adjustment reduced these risk ratios to 1.2 and 2.1, respectively. Some 2.9% of all social assistance entries may be attributed to parental psychiatric diagnoses while somatic health records account for another 7.2%, making their total contribution over 1/10th of all cases. Conclusions: Parental specialised healthcare records were associated with a higher risk of social assistance need. Thus more interventions to support financial management are required for parents with psychiatric diagnoses.

Low birth phenomenon is a global trend with an important economic and societal consequences that stress global and holistic initiatives in western countries. This paper attempts to contribute to this issue by developing an original approach to mine parenthood patterns from Twitter social media platform. Relevant hashtags are employed to develop a social network-based approach to distinguish relevant communities. The three relevant online communities were identified. We conducted a topical based analysis to comprehend the discussion trend and sentiment analysis to further monitor issues of parenthood concerns. Examples of concerns raised by the community analysis include anxiety in autism parenting, stress in single parenting, college loans, and debts in pandemic time.

The marginalisation of youths, youth unemployment, and exacerbated mental disorders are problematic in terms of the structures of the welfare state: besides being a tragedy on a personal and human level, marginalisation is also a major financial burden on the state, due to the involvement of the different remedial, preventative, and supportive social and health care services needed, as well as due to lost tax income. In order to protect children and adolescents from becoming marginalised, information is needed on the well-being of young adults and the role the social factors related to their childhood and adolescence have in it. This information makes it possible to use the services and benefits system to influence the social factors, as well as direct tax revenues at proactive health care services. It is cheaper to direct tax revenues at proactive and timely services than it is to take remedial action. The goal of the study, therefore, is to identify the risk factors associated with well-being and to substantiate the correlation between them and the response to well-being. It is in the interests of both the youths and the state to support the development of the well-being of children and adolescents, the future taxpayers, thereby harnessing their individual potential to benefit the structures of the welfare state. In this thesis, the focus is on mental health and early school leaving of children born in Finland 1987. The children in question have been followed over time based on longitudinal, register-based 1987 Finnish Birth Cohort data (N = 59,476). In this study, social factors that are linked to mental disorders and early dropping out of school are examined from the standpoint of Allardt’s sociological theory of welfare, life course approach and social epidemiology. Based on earlier literature, parental mental disorders are associated to with offsprings’ mental disorders. According to our study, parental mental disorders are associated even more closel, Tiivistelmä Nuorten syrjäytyminen, nuorisotyöttömyys ja vaikeutuneet mielenterveysongelmat ovat ongelmallisia hyvinvointivaltion rakenteiden kannalta, sillä inhimillisen ja henkilökohtaisen tragedian lisäksi syrjäytyminen on myös suuri kansantaloudellinen kustannusrasite yhteiskunnalle eri korjaavien, ehkäisevien, hyvinvointia tukevien palveluiden käytön ja menetettyjen verotulojen muodossa. Suojellaksemme lapsia ja nuoria syrjäytymiseltä tarvitaan tietoa nuorten aikuisten hyvinvoinnista ja lapsuuden ja nuoruuden aikaisten sosiaalisten tekijöiden yhteyksistä siihen. Tiedon avulla voidaan sekä pyrkiä vaikuttamaan sosiaalisiin tekijöihin mm. palvelu- ja etuusjärjestelmän avulla että kohdentaa verorahoja hyvinvointia ennakoiviin palveluihin. Verovarojen kohdentaminen ennakoiviin ja oikea-aikaisiin palveluihin on korjaavia toimenpiteitä edullisempi ratkaisu. Tutkimuksen tavoitteena onkin tunnistaa hyvinvoinnin riskitekijöitä ja todentaa niiden ja hyvinvointivasteiden välisiä yhteyksiä. Lasten ja nuorten, tulevien veronmaksajien hyvinvoinnin kehityksen tukeminen on nuorten oman edun lisäksi myös yhteiskunnan edun mukaista, jotta yksilöiden potentiaali voidaan valjastaa tukemaan hyvinvointivaltion ja yhteiskunnan rakenteita. Tässä väitöskirjassa tarkastellaan vuonna 1987 Suomessa syntyneiden mielenterveyttä ja koulutusastetta pitkittäisellä Kansallinen syntymäkohortti 1987 -rekisteriaineistolla (N = 59 476). Mielenterveyden häiriöihin ja lyhyeen koulutuspolkuun yhteydessä olevia sosiaalisia tekijöitä tarkastellaan Allardtin hyvinvointiteorian, elämänkulun ja sosiaaliepidemiologian näkökulmasta. Aiemman kirjallisuuden mukaan vanhempien mielenterveyden häiriöt ovat yhteydessä heidän lastensa mielenterveyden häiriöihin. Tutkimuksemme mukaan vanhempien mielenterveysongelmat ovat yhteydessä myös astetta pidemmälle heidän lastensa mielenterveysperustaiseen työkyvyttömyyteen. Yllättäen isän matalampi koulutusaste, perusaste ja keskiaste, näyttäytyy mielenterveysperustaiselta työ

Background: Families with parental mental health issues often have numerous problems needing multilevel measures to address them. The “Let’s Talk about Children Service Model (LT-SM)” is a community-based service approach aiming at collectively impacting population needs regarding child protection services. Three municipalities in the Raahe District (RD) of Finland requested implementation of the LT Service Model. This paper describes the model and first results. Methods: The LT Service Model connects relevant stakeholders with families and their social networks aiming at the shared goal of supporting children’s everyday life at home, kindergarten, school, and leisure environments. Parents, teachers, and other caretakers are supported by LT interventions. An infrastructure for collaboration, decision making, monitoring, training, and feedback is established, embracing health, social and educational services, and other stakeholders. Referrals to child protection services were compared with national data before (2009–2013) and after implementation of the LT Service Model (2013—2016). Analyses were conducted using the joinpoint regression method. Results: There was a significant decrease in the underage population referred to child protection services in RD (AAPC = −6.9; p = 0.013) between 2013 and 2016, in contrast with an increased rate nationwide (AAPC = 1.9; p = 0.020). Conclusion: In the LT Service Model, prevention starts in children’s everyday life as the uniting, common goal for multiple stakeholders and an integrated service structure is developed to support this effort. The first results are promising, showing an appreciable decrease in referrals to child protection services, although further research with longer follow-up and across other municipalities is needed.

Cumulative contributions of social and health-related determinants to long-term unemployment during early working life among young adults are poorly understood. Therefore, we used four cumulative indices of both parental and own social and health-related determinants of such unemployment among a cohort which comprised a complete census of children born in Finland in 1987. The cohort participants were registered in the Medical Birth Register, and they were followed-up through 2015 (N = 46 521). We calculated predicted probabilities for long-term unemployment (> 12 months) when participants were 25–28 years. Moreover, we examined whether the associations differed by unemployment at the municipal level. During the follow-up, 4.5% of women and 7.1% of men experienced long-term unemployment. All cumulative indices of parental and own social and health-related determinants predicted the probability of long-term unemployment. The greatest probabilities were observed for own social determinants, both in municipalities with high and low unemployment although the probabilities were higher in the high-unemployment municipalities. Of the individual determinants, poor school performance showed the strongest association with long-term unemployment among women (OR 6.65, 95% CI 5.21–8.55) and men (OR 3.70, 95% CI 2.96–4.67), after adjusting for other own social determinants. The results highlight the importance of life course social equality in the prevention of long-term unemployment in early adulthood.

Background: Psychiatric disorders tend to be developmental, and longitudinal settings are required to examine predictors of psychiatric phenomena. Replicating and combining data and results from different birth cohorts, which are a source of reliable data, can make research even more valuable. The Finnish Psychiatric Birth Cohort Consortium (PSYCOHORTS) project combines birth cohorts in Finland. Aim: The aim of this paper is to introduce content, plans and perspectives of the PSYCOHORTS project that brings together researchers from Finland. In addition, we illustrate an example of data harmonization using available data on causes of death. Content: PSYCOHORTS includes eight Finnish birth cohorts. The project has several plans: to harmonize different data from birth cohorts, to incorporate biobanks into psychiatric birth cohort research, to apply multigenerational perspectives, to integrate longitudinal patterns of marginalization and inequality in mental health, and to utilize data in health economics research. Data on causes of death, originally obtained from Finnish Cause of Death register, were harmonized across the six birth cohorts using SAS macro facility. Results: Harmonization of the cause of death data resulted in a total of 21,993 observations from 1965 to 2015. For example, the percentage of deaths due to suicide and the sequelae of intentional self-harm was 14% and alcohol-related diseases, including accidental poisoning by alcohol, was 13%. Conclusions: PSYCOHORTS lays the foundation for complex examinations of psychiatric disorders that is based on compatible datasets, use of biobanks and multigenerational approach to risk factors, and extensive data on marginalization and inequality.

Background/Objectives: Parental mental disorders have been shown to predict offspring‘s mental health problems. We examined whether pathways from parental mental disorders to offspring‘s psychiatric work disability in early adulthood are mediated through offspring‘s mental disorders and social disadvantage in adolescence. Methods: Study population consisted of the 1987 Finnish Birth Cohort. Data on parents‘ psychiatric care or work disability due to mental diagnosis between 1987 and 2000 and the cohort participants‘ health and social factors between 2001 and 2005 were derived from administrative national registers. From 2006 through 2015, 52,182 cohort participants were followed for admittance of psychiatric work disability due to depressive or anxiety disorders. First, we applied a pathway analysis to examine the occurrence of each path. We then used mediation analysis to assess the proportion of association between parental mental disorders and work disability mediated by offspring‘s health and social disadvantage. Results: The pathway model indicated that the association from parental mental disorders to offspring‘s work disability due to depressive or anxiety disorder is through mental disorders and social disadvantage in adolescence. Odds Ratio for the total effect of parental mental disorders on offspring‘s psychiatric work disability was 1.85 (95% confidence interval [CI] 1.46–2.34) in the model including offspring‘s mental disorders that mediated this association by 35%. Corresponding results were 1.86 (95% CI 1.47–2.35) and 28% for social disadvantage in adolescence. Conclusions: These findings suggest that intergenerational determination of work disability due to mental disorders could be addressed by actions supporting mental health and social circumstances in adolescence.

Objective: To investigate whether parental TBI increases the overall risk for psychiatric disorders and the risk for specific psychiatric diagnoses in the children affected by parental TBI. Methods: The 1987 Finnish Birth Cohort (n = 59 476) were followed up through national registers from birth to the end of 2008. The diagnoses of cohort members and their parents were obtained from the Care Register of Health Care, provided by the National Institute of Health and Welfare. Results: During the 21-year follow-up, the likelihood for psychiatric diagnoses being assessed in psychiatric care was significantly increased in males with any mental disorder (odds ratio (OR) = 1.43), substance-use-related disorders (OR = 1.71) and behavioural and emotional disorders (OR = 1.75), and in females with disorders of psychological development (OR = 1.85). Conclusions: Children affected by parental TBI are at increased risk for psychiatric disorders: males for externalizing disorders and females for developmental disorders. Observed gender interactions in the association between parental TBI and the psychiatric disorders of children warrant further study.