Educational attainment in offspring bereaved by sudden parental death from external causes: a national cohort study from birth and throughout adulthood

Abstract

Purpose Previous research has linked loss of a parent during childhood to reduced educational aspirations, school performance, and educational attainment later in life. The potential effect of maternal and paternal bereavement on attainment at all educational levels is, however, unknown. The present study aimed to investigate the potential influence of parental death by external causes on completion of compulsory education, high school, vocational education, and University or College education. Methods The study was based on data from three national longitudinal registers in Norway. The study population comprised 373,104 individuals born between January 1st 1970 and December 31st 1994. Information concerning deceased parents' cause and date of death and offspring's education and sociodemographic data were retrieved. Data were analysed with Cox regression. Results Children who had experienced parental death by external causes had a significantly reduced hazard ratio (HR) of completing all educational levels compared to children who did not have such experiences. The largest effects were evident for completion of high school (HR 0.68, 95% CI 0.65-0.71) and University or College education (HR 0.75, 95% CI 0.70-0.80). No differences were evident for different causes of death, genders of deceased or ages at bereavement, and generally no significant interactions between gender of the bereaved offspring and predictor variables were evident for completion of all educational levels. Conclusion Parental death by external causes has vast and long-lasting impacts on offspring's educational attainment at all levels. Health care interventions aimed at supporting bereaved children and adolescents should focus on challenges related to educational progress.

Parental death by external causes and risk of hospital-treated deliberate self-harm in bereaved offspring

“…Results from the present study reporting an increased risk of DSH hospitalization in bereaved offspring are consistent with prior Scandinavian register studies [5,[10][11][12][13][14][15]17], and add to the literature, suggesting that many bereaved offspring in Norway suffer from extensive psychosocial sequela [6,7]. The explanation for the increased risk following bereavement may to a certain degree lie in the covariates included in the study, since the associations were attenuated in the multivariate analyses and all covariates significantly predicted DSH hospitalization.…”

“…Naturally, the children of the deceased are highly impacted by this loss given the broken attachment to a primary care giver [3] and the direct effect of loss on daily life [4]. The sudden death of a parent is consequently associated with an increased risk of longterm psychosocial sequela [5][6][7], and several Scandinavian population-based register studies have reported an increased risk of hospital treatment for deliberate self-harm (DSH) in bereaved offspring [5,[8][9][10][11][12][13][14][15][16][17]. When directly comparing offspring bereaved by suicide and accidents, researchers have reported an earlier onset of DSH hospitalization in offspring following parental suicide compared to those parentally bereaved by accidental death [9].…”

Cause of parental death and child's health and education: The role of parental resources

“…Causes of death were classified according to the International Classification of Diseases (ICD-10) as (1) natural deaths (diseases) or deaths by external causes (accident, violence, or suicide [ICD-10 code: V01–Y89]). A similar classification was used in many other Nordic studies (e.g., Burrell et al, 2020 ; Berg et al, 2014 ; Rostila and Saarela, 2011 ). The parental death variables consisted of the following values: 0 alive (no parental death), 1 external death, 2 natural death, based on the primary causes of death, since the secondary causes were not available in the data.…”

“…Evidence on the cause of parental death and educational outcomes is based on a few studies, in which external deaths that are sudden or otherwise more traumatic, had the strongest associations with lower grades and a higher drop-out at compulsory school in Sweden ( Berg et al, 2014 ), and with impeded college or university enrolment in Taiwan ( Chen et al, 2009 ; Gimenez et al, 2013 ) and Norway ( Burrell et al, 2020 ). According to our knowledge, there are no studies that have examined the role of cause of parental death on early disability pension, which is an indicator of severely poor health and functioning.…”

“…Both cause of parental death and family's resources are potential sources of variation in health and educational performance after bereavement, but there is much less evidence on this (e.g., Appel et al, 2016 ; Berg et al, 2014 ; Burrell et al, 2020 ; Chen et al, 2009 ; Gimenez et al, 2013 ). External or unnatural causes of death due to accident, violence, or suicide are generally linked to more adverse child outcomes, such as higher risk of depression, lower education, and self-inflicted injuries, compared with natural deaths by diseases ( Berg et al, 2016 ; Burrell et al, 2020 ; Chen et al, 2009 ; Rostila et al, 2016 ; Rostila & Saarela, 2011 ). There is also some evidence that losing a mother unexpectedly is more adverse than a father's sudden death ( Chen et al, 2009 ).…”