Employment, health visits, mental health, and mortality in parents with a chronically ill child: a Danish nationwide population-based cohort study
Research output: Contribution to journal › Journal article › Research › peer-review
Standard
Employment, health visits, mental health, and mortality in parents with a chronically ill child : a Danish nationwide population-based cohort study. / Boesen, Magnus Spangsberg; Thygesen, Lau Caspar; Blinkenberg, Morten; Born, Alfred Peter; Uldall, Peter; Magyari, Melinda; Eriksson, Frank.
In: European Journal of Pediatrics, Vol. 181, 2022, p. 1547–1555.Research output: Contribution to journal › Journal article › Research › peer-review
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
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 -
ID: 291532562