Social determinants of mortality after leaving parental home – effects of childhood and current sociodemographic factors

Hanna Remes, University of Helsinki
Pekka Martikainen, University of Helsinki

Most research on life course effects on health has concerned adult and older populations and life course trajectories have often relied on only few measurement points. From a life course perspective, early adulthood is an important transitional period as the taken paths in education, employment, and family formation seem to affect health differentials over the effects of preceding childhood living conditions. This study examines mortality differentials in late adolescence and early adulthood by both parental background (family structure in childhood, parental education, occupational class, and income) and current living arrangements, level of own education, and current main economic activity. Mortality is followed from the point of leaving parental home, an important threshold in the transition to adulthood that generally occurs early in Northern Europe. The study is based on longitudinal register data that include a representative 11% sample of the Finnish population with an over-sample of 80% of all deaths. We calculated mortality rates and estimated Cox proportional hazards models to study deaths between ages 17–29 from 1990 to 2007. Strong excess mortalities were found among young people with lower education, the non-employed, and those living without a partner. The effects of parental background on mortality in early adulthood were largely, but not entirely, mediated by the current sociodemographic factors, education in particular. Adjusting for both childhood and current factors, early age at leaving parental home remained an independent risk factor for premature death. The strength of the social determinants of mortality among the young was mainly driven by external causes of death, but to a lesser extent deaths due to diseases contributed to differentials as well.