Jag är professor i socialt arbete med inriktning mot kvantitativa metoder och docent i sociologi.
Mina forskningsintressen omfattar flera interdisciplinära ämnen i skärningspunkten mellan socialt arbete, sociologi, epidemiologi och folkhälsa. Vanligtvis med utgångspunkt i individuella registerdata inbegriper nuvarande forskning: 1) Longitudinella studier av social, ekonomisk och hälsomässig ojämlikhet i sårbara populationer som exempelvis individer med erfarenhet av insatser inom den sociala barnavården, och 2) Resultat av sociala interventioner.
Utöver handledning på avancerad och doktorandnivå undervisar jag på följande kurser:
- Socionomprogrammets sjätte termin: Forskningsmetoder, 7.5 hp.
- Implementering och utvärdering av socialt arbete, 7.5 hp
- Kvantitativ forskningsmetod, 7.5 hp.
- Samhällsarbete i marginaliserade områden, 7.5 hp.
I urval från Stockholms universitets publikationsdatabas
Outcomes in Adulthood After Long-Term Foster Care
2020. Lars Brännström, Bo Vinnerljung, Anders Hjern. Child MaltreatmentArtikel
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 siblings, in which some were placed in foster care and others remained in their birth parents’ care, this study asks whether long-term foster care ensures improved life chances. Results from multilevel regression analyses of a wide range of educational, social, and health-related outcomes in mature adult age (16 outcome constructs) support a row of previous studies indicating that traditional long-term foster care does not seem to improve maltreated children’s life chances.
Inequalities in educational outcomes in individuals with childhood experience of out-of-home care
2020. Lars Brännström (et al.). PLoS ONE 15 (4)Artikel
Prior research has shown that individuals with experience of out-of-home care (foster family care or residential care) in childhood are educationally disadvantaged compared to their peers. In order to be better equipped to design interventions aimed at improving the educational outcomes of children for whom society has assumed responsibility, this study seeks to further our understanding about which factors that contribute to the educational disparities throughout the life course.
Using longitudinal data from a cohort of more than 13,000 Swedes, of which around 7% have childhood experience of out-of-home care, Peters-Belson decomposition is utilized to quantify the extent to which the gap in educational achievement in school (age 16) and midlife educational attainment (age 50) captures differences in the prevalence of factors influencing educational outcomes, and differences in the impacts between these factors.
We find that the achievement and the attainment gap was around 13% and 9% respectively. These gaps were to a large extent explained by differences in the distribution of predictors. The major explanatory factor for placed children’s lower achievement was a lower average cognitive ability. Yet there were some evidence that the rewards of cognitive ability in these children differed across the life course. While the lower returns of cognitive ability suggest that they were underperforming in compulsory school, the higher returns of cognitive ability on midlife attainment indicate that–given previous underperformance–their attainment at age 50 reflects their cognitive capacity more accurately than their achievement at age 16 do.
The large influence of the unequal distribution of predictors suggests that policy efforts are needed to promote equity in the distribution of factors contributing to educational achievement and attainment. Since cognitive ability was found to be an important contributory factor, such efforts may include promoting cognitive and intellectual development among children in out-of-home care, preferably starting at a young age.
Outcomes in adulthood of adoption after long-term foster care
2019. Anders Hjern, Bo Vinnerljung, Lars Brännström.Artikel
Prior research has reported a positive impact of adoption on developmental outcomes for children with experience of foster care. To inform decisions about permanent care arrangements, we used Swedish national population registers to create a sibling population consisting of 194 children born 1973–1982 who had been in out-of-home care (OHC) at least 5 years before adolescence but were never adopted (50% boys) and their 177 maternal birth siblings who also had been in OHC at least 5 years before their teens but were adopted before adolescence (52.5% boys). We constructed 14 outcome variables spanning social, educational, and health outcomes in adult age with information from Swedish national registers. Based on multilevel logistic random effects and fixed effects regression models (supplemented with a sensitivity analysis assessing the potential impact of unobserved confounding), results showed that adopted siblings tended to have considerably better outcomes in adult age in educational achievement, income, criminality, disability, and suicidality. Outcomes related to mental health and substance abuse were more similar, but differences pointed in the same direction. Implications for child welfare policy and practice are discussed.
Do trajectories of economic, work- and health-related disadvantages explain child welfare clients’ increased mortality risk? A prospective cohort study
2019. Ylva B. Almquist, Lars Brännström. BMC Public Health 19Artikel
Past research has shown that individuals who have had experiences of out-of-home care (OHC) in childhood have increased risks of premature mortality. Prior studies also suggest that these individuals are more likely to follow long-term trajectories that are characterised by economic, work-, and health-related disadvantages, compared to majority population peers. Yet, we do not know the extent to which such trajectories may explain their elevated mortality risks. The aim of this study is therefore to examine whether trajectories of economic, work-, and health-related disadvantages in midlife mediate the association between OHC experience in childhood and subsequent all-cause mortality.
Utilising longitudinal Swedish data from a 1953 cohort (n = 14,294), followed from birth up until 2008 (age 55), this study applies gender-specific logistic regression analysis to analyse the association between OHC experience in childhood (ages 0–19; 1953–1972) and all-cause mortality (ages 47–55; 2000–2008). A decomposition method developed for non-linear regression models is used to estimate mediation by trajectories of economic, work-, and health-related disadvantages (ages 39–46; 1992–1999), as indicated by social welfare receipt, unemployment, and mental health problems. To account for selection processes underlying placement in OHC, an alternative comparison group of children who were investigated by the child welfare committee but not placed, is included.
The results confirm that individuals with experience of OHC have more than a two-fold increased risk of all-cause mortality, for men (OR: 2.10, 95% CI: 1.42–3.11) and women (OR: 2.23, 95% CI: 1.39–3.59) alike. Approximately one-third (31.1%) of the association among men, and one-fourth (27.4%) of the association among women, is mediated by the long-term trajectories of economic, work-, and health-related disadvantages. The group who were investigated but not placed shows similar, yet overall weaker, associations.
Individuals who come to the attention of the child welfare services, regardless of whether they are placed in out-of-home care or not, continue to be at risk of adverse outcomes across the life course. Preventing them from following trajectories of economic, work-, and health-related disadvantages could potentially reduce their risk of premature death.
Educational outcomes of children from long-term foster care
2019. Marie Berlin (et al.). Developmental Child Welfare 1 (4), 344-359Artikel
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-term foster care, this study explores the hypothesized mediating role of foster parents’ educational attainment on foster children’s educational outcomes, here conceptualized as having poor school performance at age 15 and only primary education at age 26. Results from gender-stratified regression analyses suggest that there was an association between foster parental educational attainment and foster children’s educational outcomes but that the educational transmission was weak and inconsistent and differed somewhat between males and females. For males, lower educational attainment in foster parents was associated with poor school performance but was not associated with educational attainment at age 26. The reverse pattern was found among females: the educational gradient was inconsistent for poor school performance but appeared in educational attainment. The results indicate that supported interventions for improving foster children’s educational achievements are needed, even when placements are relatively stable and foster parents have a long formal education.
Housing Evictions and Economic Hardship. A Prospective Study
2018. Anna Kahlmeter, Olof Bäckman, Lars Brännström. European Sociological Review 34 (1), 106-119Artikel
Research has demonstrated that evictions primarily affect vulnerable populations. However, relatively little is known about the consequences eviction has, particularly regarding economic outcomes. Using comprehensive Swedish national register data on evictions in 2009, this study tests two competing hypotheses regarding to what extent an eviction affects subsequent economic hardship for an already disadvantaged group. The degree to which individuals rely on means-tested social assistance is used as an indicator of economic hardship. The cumulative disadvantage perspective predicts that additional strain will compound the economic hardship experienced by the group. In contrast, the disadvantage saturation perspective suggests that additional adversities may not add to economic hardship for disadvantaged individuals. Results from propensity score matching analyses show that, the year immediately after eviction, the degree of social assistance receipt was around 8 percentage points higher for the evicted group than for the matched comparison group. In the following 3 years, the degree of social assistance receipt continued to be significantly higher for those evicted compared to peers. The results lend support to the cumulative disadvantage perspective and suggest that—in the context of preventing evictions—policy measures such as assistance to repay rent arrears would be adequate to prevent further economic hardship.
Exposure to out-of-home care in childhood and adult all-cause mortality
2017. Menghan Gao, Lars Brännström, Ylva Almquist B.. International Journal of EpidemiologyArtikel
Background: Children placed in out-of-home care (OHC) have exceedingly high rates of health problems. Their poor health tends to persist across adolescence and into young adulthood, resulting in increased risks of mortality. Yet, very little is known about this group’s mortality risks later in life. The aim of this study was to investigate whether OHC was associated with the risk of all-cause mortality across adulthood, and whether these risks varied across different placement characteristics. Moreover, the study addressed potential confounding by including two comparison groups with children who grew up under similarly adverse living conditions but did not experience placement.
Methods: Data were derived from a 60-year follow-up of a Stockholm cohort born in 1953 (n = 15 048), of whom around 9% have had experiences of OHC. The associations between OHC and subsequent all-cause mortality were analysed by means of Cox’s proportional hazards regression models.
Results: Individuals who were placed in OHC at any point during their formative years had increased mortality risks across ages 20 to 56 years. Elevated risk of mortality was particularly pronounced among those who were placed in adolescence and/or because of their own behaviours. Children who were exposed to OHC had increased risks of mortality also when compared with those who grew up under similar living conditions but did not experience placement.
Conclusions: Children in OHC constitute a high-risk group for subsequent mortality. In order to narrow the mortality gap, interventions may need to monitor not only health aspects but also to target the cognitive and social development of these children.
Aggression replacement training (ART) for reducing antisocial behavior in adolescents and adults
2016. Lars Brännström (et al.). Aggression and Violent Behavior 27, 30-41Artikel
Aggression Replacement Training (ART) is a multimodal program aiming at replacing antisocial behaviors by actively teaching desirable behaviors. The program is frequently used and has been provided within a wide variety of settings, but its effectiveness in its own right has not been addressed in previous reviews. This systematic review examines the effect of ART on antisocial behavior in young people and adults.
Published and unpublished literature was searched to identify randomized and non-randomized studies comparing ART for adults and youth with usual care, other interventions, or no intervention. Primary outcomes included recidivism in antisocial behavior, while secondary outcomes were related to social skills, anger management and moral reasoning.
This review identified 16 studies with considerable clinical and methodological diversity. The methodological quality and the post-intervention follow-up of the studies were limited. Almost half of the studies were conducted by researchers who have vested interests in the intervention.
There is an insufficient evidence-base to substantiate the hypothesis that ART has a positive impact on recidivism, self-control, social skills or moral development in adolescents and adults. Further research is warranted by independent investigators exploring the effects of ART on clearly-defined target groups using high standard evaluation designs.
The truly disadvantaged? Midlife outcome dynamics of individuals with experiences of out-of-home care
2016. Lars Brännström (et al.). International Journal of Child Abuse & NeglectArtikel
Little is known about developmental outcomes in midlife of persons who were placed in out-of-home care (OHC) in childhood. Utilizing longitudinal Swedish data from a cohort of more than 14,000 individuals who we can follow from birth (1953) to the age of 55 (2008), this study examines midlife trajectories of social, economic, and health-related disadvantages with a specific focus on the complexity, timing, and duration of disadvantage in individuals with and without childhood experience of OHC. Roughly half of the OHC alumni did not have disadvantaged outcomes in midlife. However, experience of OHC was associated with a two-fold risk for various forms of permanent disadvantage, net of confounding factors. Implications for research, policy, and practice are discussed.
Spatial spillover effects of a community action programme targeting on-licensed premises on violent assaults
2016. Lars Brännström, Björn Trolldal, Martin Menke. Journal of Epidemiology and Community Health 70 (3), 226-230Artikel
Background Spatial dependencies may influence the success of community action strategies to prevent and reduce harmful alcohol use. This study examined the effectiveness of a multicomponent Responsible Beverage Service (RBS) programme targeting on-licensed premises on police-recorded assaults in Swedish municipalities. It was expected that the implementation of the programme within any given municipality had an indirect effect by reducing violent assaults in adjacent municipalities.
Methods This study was a natural experiment exploiting the temporal and spatial variation in the implementation of the RBS programme to predict change in the rate of violent assaults in all Swedish municipalities during 1996–2009 (n=288; T=14; N=4 032). Yearly police-recorded violent assaults per 100 000 inhabitants aged 15 and above committed on weekend nights were used as a dependent variable. Programme fidelity was identified by means of survey data. A semilogarithmic fixed-effects spatial panel regression model was used to estimate the direct, indirect and total effects of the programme.
Results The direct, indirect and total effects were −1.8% (95% CI −4.4% to 0.8%), −5.8% (95% CI −11.5% to −0.1%) and −7.6% (95% CI −13.2% to −2.2%), respectively. Averaged over time and across all municipalities, implementing one additional programme component in all municipalities will thus reduce violent assaults in one typical municipality by nearly 8%.
Conclusions The indirect effect of the programme was three times larger than its direct effect. Failing to account for such local spillover effects can result in a considerable underestimation of the programme's total impact and may lead to erroneous policy recommendations.
Does poor school performance cause later psychosocial problems among children in foster care? Evidence from national longitudinal registry data
2016. Hilma Forsman (et al.). International Journal of Child Abuse & Neglect 57, 61-71Artikel
Research has shown that children in foster care are a high-risk group for adverse economic, social and health related outcomes in young adulthood. Children's poor school performance has been identified as a major risk factor for these poor later life outcomes. Aiming to support the design of effective intervention strategies, this study examines the hypothesized causal effect of foster children's poor school performance on subsequent psychosocial problems, here conceptualized as economic hardship, illicit drug use, and mental health problems, in young adulthood. Using the potential outcomes approach, longitudinal register data on more than 7500 Swedish foster children born 1973–1978 were analyzed by means of doubly robust treatment-effect estimators. The results show that poor school performance has a negative impact on later psychosocial problems net of observed background attributes and potential selection on unobservables, suggesting that the estimated effects allow for causal interpretations. Promotion of school performance may thus be a viable intervention path for policymakers and practitioners interested in improving foster children's overall life chances.
Visa alla publikationer av Lars Brännström vid Stockholms universitet