TY - JOUR

T1 - Employment, health visits, mental health, and mortality in parents with a chronically ill child

T2 - a Danish nationwide population-based cohort study

AU - Boesen, Magnus Spangsberg

AU - Thygesen, Lau Caspar

AU - Blinkenberg, Morten

AU - Born, Alfred Peter

AU - Uldall, Peter

AU - Magyari, Melinda

AU - Eriksson, Frank

N1 - Publisher Copyright: © 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

PY - 2022

Y1 - 2022

N2 - Chronic diseases in children can impact their parents; this may be overlooked in a clinical setting. Our aim was to investigate associations of chronic diseases in children with their parents’ employment, health care utilization, mental health, and mortality. In a matched cohort study using nationwide and population-based data in Denmark, we included parents to children (< 18 years) with acute disseminated encephalomyelitis, multiple sclerosis, type 1 diabetes, inflammatory bowel disease, and rheumatoid arthritis/juvenile idiopathic arthritis during 2008–2015. The reference group was parents to unaffected children. Outcomes were parental employment (early retirement, cash benefits, income), health care utilization (e.g., general practitioner, or hospital visits), mental health (visits to psychiatry/psychology clinics, antidepressant drug redemptions), and mortality. We included 13,769 parents with a chronically ill child and 138,606 control parents. Annual income was unaffected for two-parent families after the child’s disease onset, but two-parent families had increased hazard of early retirement of 25% (95% CI = 1.01–1.54; p = 0.04). Parents with a chronically ill child had (a) increased rate of antidepressant drug redemptions or psychology/psychiatry visits (hazard ratio 1.37; 95% CI = 1.28–1.46 at 1-year follow-up); (b) increased health care utilization, with an increased marginal mean in primary care of 1% (95% CI = 1.00–1.02; p = 0.005), hospital-affiliated visits of 19% (95% CI = 1.14–1.24; p < 0.0001), and hospital admissions of 14% (95% CI = 1.09–1.20; p < 0.0001); and (c) 69% increased mortality hazard (95% CI = 1.30–2.18; p < 0.0001) in parents younger than 50 years with no comorbidities, albeit small in absolute numbers. Conclusion: Pediatric chronic diseases were negatively associated with parental employment, mental health, and mortality, and increased health care utilization.What is Known:• Studies on the impact of pediatric chronic diseases on parental health are qualitative.• Knowledge is unavailable regarding the impact on parental work, health care utilization, and mortality.What is New:• Among 13,769 parents with a chronically ill child and 138,606 control parents, parents with a chronically ill child had 37% increased antidepressant drug redemptions, and these parents <50 years without comorbidities had 69% increased mortality hazard.• Medical doctors should consider the parental health condition and societal challenges related to having child with a chronic disease.

AB - Chronic diseases in children can impact their parents; this may be overlooked in a clinical setting. Our aim was to investigate associations of chronic diseases in children with their parents’ employment, health care utilization, mental health, and mortality. In a matched cohort study using nationwide and population-based data in Denmark, we included parents to children (< 18 years) with acute disseminated encephalomyelitis, multiple sclerosis, type 1 diabetes, inflammatory bowel disease, and rheumatoid arthritis/juvenile idiopathic arthritis during 2008–2015. The reference group was parents to unaffected children. Outcomes were parental employment (early retirement, cash benefits, income), health care utilization (e.g., general practitioner, or hospital visits), mental health (visits to psychiatry/psychology clinics, antidepressant drug redemptions), and mortality. We included 13,769 parents with a chronically ill child and 138,606 control parents. Annual income was unaffected for two-parent families after the child’s disease onset, but two-parent families had increased hazard of early retirement of 25% (95% CI = 1.01–1.54; p = 0.04). Parents with a chronically ill child had (a) increased rate of antidepressant drug redemptions or psychology/psychiatry visits (hazard ratio 1.37; 95% CI = 1.28–1.46 at 1-year follow-up); (b) increased health care utilization, with an increased marginal mean in primary care of 1% (95% CI = 1.00–1.02; p = 0.005), hospital-affiliated visits of 19% (95% CI = 1.14–1.24; p < 0.0001), and hospital admissions of 14% (95% CI = 1.09–1.20; p < 0.0001); and (c) 69% increased mortality hazard (95% CI = 1.30–2.18; p < 0.0001) in parents younger than 50 years with no comorbidities, albeit small in absolute numbers. Conclusion: Pediatric chronic diseases were negatively associated with parental employment, mental health, and mortality, and increased health care utilization.What is Known:• Studies on the impact of pediatric chronic diseases on parental health are qualitative.• Knowledge is unavailable regarding the impact on parental work, health care utilization, and mortality.What is New:• Among 13,769 parents with a chronically ill child and 138,606 control parents, parents with a chronically ill child had 37% increased antidepressant drug redemptions, and these parents <50 years without comorbidities had 69% increased mortality hazard.• Medical doctors should consider the parental health condition and societal challenges related to having child with a chronic disease.

KW - Employment

KW - Health care utilization

KW - Mental health

KW - Mortality

KW - Parents

KW - Pediatric chronic disease

U2 - 10.1007/s00431-021-04334-2

DO - 10.1007/s00431-021-04334-2

M3 - Journal article

C2 - 35059826

AN - SCOPUS:85123238696

VL - 181

SP - 1547

EP - 1555

JO - Acta Paediatrica Hungarica

JF - Acta Paediatrica Hungarica

SN - 0340-6199

ER -