Educational Achievements, Labor Market Attachment and Family Establishment in Children of Parents or Siblings with Acquired Brain or Spinal Cord Injury: A Nationwide Register Study

OBJECTIVE: To investigate long-term socioeconomic consequences on children experiencing acquired brain injury (ABI) or spinal cord injury (SCI) in a parent or sibling.

DESIGN: Nationwide register-based study.

SETTING: Through Danish national population register data, we identified an exposed cohort of children and a nonexposed reference population born in Denmark between 1977 and 2006.

PARTICIPANTS: The study population (N=111,405) comprised children who experienced familial injury before the age of 18, divided into 4 groups: (1) children of a parent with ABI (n=74,227); (2) children with a sibling with ABI (n=32,664); (3) children of a parent with SCI (n=3557); and (4) children with a sibling with SCI (n=957). They were compared with the reference population (n=2,180,207) using linear and logistic regression models.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: (1) Lower secondary school achievements and upper secondary educational attainment; (2) labor market attachment; and (3) family establishment and disruption.

RESULTS: Children affected by familial injury achieved significantly lower grade point average in lower secondary school, with the highest adjusted mean difference in group B (-0.44 [-0.47 to -0.41]). Children had a lower probability of commencing and completing upper secondary education, with the lowest adjusted odds ratio for these outcomes in group D (0.47 [0.25-0.90]) and group B (0.48 [0.46-0.49]), respectively. In addition, these children had a higher probability of long-term sick leave and disability pension, lower probability of establishing a family, and higher risk of divorce by age 26.

CONCLUSIONS: This study documented that children exposed to familial injury were significantly affected across several socioeconomic parameters. These findings highlight the risk of social inequality and emphasize the need for supportive interventions to safeguard their social security.