Responses to increased alcohol availability may vary across the population as a function of differential vulnerability. This study therefore aimed to examine the effects of the implementation of Saturday opening at the Swedish alcohol retail monopoly in 2000 on risks of hospitalization due to external causes (HEC) among different population subgroups. Leveraging the experimental design of the reform, longitudinal difference-in-differences analyses were applied to a register-based cohort of individuals aged 20-40 at the time of implementation. The population was stratified into groups of Swedish, Finnish, and Middle Eastern origin, known to represent different levels of alcohol consumption and rates of alcohol-related morbidity. Results showed a 17.7% increase (P <. 029) in the risk of HEC among individuals of Finnish origin, as jointly caused by both increased prevalence in the experiment area and decreased prevalence in the control area. The increase was primarily driven by younger men with lower levels of education. Those of Swedish origin exhibited largely similar patterns (9.7% increase; P <. 001), while no measurable impact was observed among individuals of Middle Eastern origin (-21.4% decrease; P <. 076). The findings confirm that increasing alcohol availability contributes to the disease burden related to alcohol among population subgroups already susceptible to its effects.

Infant placement in foster care is a critical intervention, yet its long-term outcomes are largely unknown. This study examines the association between infant placement and poor labor market attachment into early midlife. Using longitudinal data from over 620,000 Swedes born 1975–1981, including 0.2% placed in care during infancy, outcomes are compared with the general population and those placed at older ages. Results from sex-stratified hurdle regression models show that infants in care face higher risks of experiencing any year with poor labor market status compared to the general population, though with lower risks than older care groups. Among those with any occurrence, the infant group exhibits higher rates of years with poor labor market status compared to the general population. Women in the infant group had significantly lower rates than those placed at older ages, while men in the infant group had higher rates than other young care groups. Implications for research, policy, and practice are discussed.

Individuals with childhood experience of out-of-home care (OHC) face elevated risks of criminal behavior and poor mental health compared with the majority population. Evidence on how trajectories of offending and psychiatric disorders covary among individuals with experience of OHC is needed. This study is based on a cohort of 14,608 individuals (n = 1,319 with OHC experience) born in the Stockholm metropolitan area in 1953 (49% women) from birth to age 63 (2016). Group-based multi-trajectory modeling among those with at least one offense or psychiatric disorder (40.5% of the men, 16.6% of the women) identified four co-occurring trajectories for both sexes. Multinomial regression analyses showed that adolescent OHC placement, particularly in institutions and for behavioral reasons, was linked to higher odds of early-adulthood-limited or decreasing offending and psychiatric trajectories. Most individuals recover from offending and psychiatric disorders by retirement, but placed individuals in particular remain at high risk for offending, alongside psychiatric disorders, throughout early adulthood. Early assessment and tailored attention to needs and risk levels is important when designing long-term care services to mitigate this. Research on underlying mechanisms, and on collaboration between the welfare, justice, and psychiatric care systems, can help to design effective intervention strategies and policies.

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-based registers, resulting in a national cohort of 881 731 of whom 26 310 (3.0%) had a history of out-of-home care. The study population, born 1972 to 1981, was followed from age 18 to age 39 to 48 years for hospitalizations and death.Results: After adjusting for year of birth and maternal education, individuals with a history of childhood out-of-home-care experienced a doubling of the risk for coronary disease (hazard ratio; 95% confidence interval: 2.05; 1.74-2.41) and stroke (hazard ratio 1.85; 1.59-2.15), compared with the general population, with similar estimates for men and women. Women with a history of out-of-home care had a more than doubled risk for cigarette smoking in early pregnancy, with a relative risk of 2.26; (2.18-2.34) and a moderately increased risk for gestational diabetes relative risk 1.49 (1.19-1.86). There was marked attenuation (40% to 90%) in effect estimates for disease and risk factors after further control for cohort members educational achievement at age 15-16 years.Conclusions: A history of childhood out-of-home care was associated with a doubled risk of early cardiovascular disease events. Cigarette smoking and educational underachievement were the main identified risk factors.

Background: Infant placements into out-of-home care have garnered increased research and societal attention, yet the long-term outcomes of this vulnerable group are virtually unknown.Objective: This study aims to examine the association between infant placement and criminal offences across the life course, contrasting with general population peers and children placed at later developmental periods.Participants and setting: The study includes 622,940 individuals born in Sweden between 1975 and 1981, among whom around 0.2 % (n = 1524) were taken into care during infancy (<12 months).Methods: Utilizing Swedish longitudinal population-based register data, sex-stratified hurdle regression analyses, adjusted for individual and family background characteristics, were conducted to investigate the risk and rates of criminal offences ages 15–38.Results: Infants placed in care exhibited higher risks of any criminal offence compared to the general population (men: RR = 1.32, p < 0.001, women RR = 1.47, p < 0.001), but lower risks compared to children placed at later ages. Incidence-adjusted rates of offences were also higher among infants compared to their general population peers (men: IRR = 2.54, p < 0.001, women: IRR = 2.77, p < 0.001), with differences to other care groups being less pronounced.Conclusions: Infant placement in care is associated with an increased risk of criminal activity over the life course.