Childhood socio-economic status, school failure and drug abuse: a Swedish national cohort study

• Published in: Addiction (Abingdon, England) Vol. 108; no. 8; pp. 1441 - 1449
• Main Authors: Gauffin, Karl, Vinnerljung, Bo, Fridell, Mats, Hesse, Morten, Hjern, Anders
• Format: Journal Article
• Language: English
• Published: Oxford Blackwell Publishing Ltd 01.08.2013; Blackwell
• Subjects: Academic failure; Addictive behaviors; Adjustment; Adolescent; Adult; Adult and adolescent clinical studies; Age; Beroendelära; Beroendelära och missbruk; Biological and medical sciences; Censuses; Childhood; Cohort analysis; Cohort Studies; cohort study; Crime - statistics & numerical data; Criminality; Demographics; Drug Abuse; Drug Abuse and Addiction; Drug addiction; Drug use; Economic status; Educational psychology; Educational Status; Elementary schools; Female; Fundamental and applied biological sciences. Psychology; General aspects; Health Sciences; High Schools; Hospitalization; Hospitalization - statistics & numerical data; Hospitals; Humans; Hälsovetenskap; Male; Medical and Health Sciences; Medical sciences; Medicin och hälsovetenskap; National registers; Parents; Psychology; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Psychopathology. Psychiatry; Psychosocial factors; Psychosocial problems; Psychosociology; Psykologi; Pupil and student. Academic achievement and failure; Risk Factors; School failure; Schools; social inequity; socio-economic status; Sociodemographics; Socioeconomic Factors; Socioeconomic Status; Substance Abuse; Substance-Related Disorders - epidemiology; Substance-Related Disorders - mortality; Substance-Related Disorders - psychology; Sweden; Underachievement; Young Adult; Young adults; Sweden; Europe; Human; Drug addiction; Socioeconomic status; Equity; Substance abuse; Epidemiology; Sweden; drug abuse; Addiction; Cohort study; socio-economic status; Childhood; social inequity; Child; Social aspect; Public health; School failure; Inequality; cohort study; school failure
• ISSN: 0965-2140; 1360-0443; 1360-0443
• DOI: 10.1111/add.12169

Aim To investigate whether socio‐economic status (SES) in childhood and school failure at 15 years of age predict illicit drug abuse in youth and young adulthood. Designsetting and participants Register study in a Swedish national cohort born 1973–88 (n = 1 405 763), followed from age 16 to 20–35 years. Cox regression analyses were used to calculate hazard ratios (HR) for any indication of drug abuse. Measurements Our outcomes were hospital admissions, death and criminality associated with illicit drug abuse. Data on socio‐demographics, school grades and parental psychosocial problems were collected from censuses (1985 and 1990) and national registers. School failure was defined as having mean school grades from the final year in primary school lower than −1 standard deviation and/or no grades in core subjects. Findings School failure was a strong predictor of illicit drug abuse with an HR of 5.87 (95% CI: 5.76–5.99) after adjustment for age and sex. Childhood SES was associated with illicit drug abuse later in life in a stepwise manner. The lowest stratum had a HR of 2.28 (95% CI: 2.20–2.37) compared with the highest stratum as the reference, when adjusted for other socio‐demographic variables. In the fully adjusted model, the effect of SES was greatly attenuated to an HR of 1.23 (95% CI: 1.19–1.28) in the lowest SES category, while the effect of school failure remained high with an HR of 4.22 (95% CI: 4.13–4.31). Conclusions School failure and childhood socio‐economic status predict illicit drug abuse independently in youth and young adults in Sweden.