Intergenerational transmission of out-of-home care in Sweden: A population-based cohort study

The objective of this study is to examine the intergenerational transmission of out-of-home care. This population-based study used data from the Swedish National Registers and included all children born in Sweden between 1990 and 2012 (followed for up to 13 years), whose parents were both born in Sweden between 1973 and 1980 (278 327 children; 145 935 mothers; 146 896 fathers). Cox regression models are used to obtain crude and adjusted hazard ratios (HR) of OHC placement among children based on parents' history of OHC. Compared with children whose parents both did not have a history of OHC, the risk of being placed in OHC was greater when both parents spent time in OHC (crude HR = 48.70, 95% CI 41.46-57.21; adjusted HR = 3.04, 95% CI = 2.54-3.64), however, children who had only one parent who spent time in care were also at higher risk (mothers only adjusted HR = 2.37, 95% CI = 2.08-2.70; fathers only adjusted HR = 1.33, 95% CI = 1.13-1.55). The crude rate of placement in OHC was highest for children whose parents were placed in care during adolescence, but after adjusting for social and behavioral covariates, children whose parents were in care in early childhood were at greater risk of OHC than children whose parents were in care in adolescence. To reduce this intergenerational transmission of OHC, more supports should be provided to parents who spent time in OHC to ensure a successful transition to parenthood.