Association of a child’s mental disorder with parental income and employment: analysis of nationwide register-based cohorts in Finland and Denmark

Background The onset of a severe physical illness of a child has been associated with earnings and employment losses among parents, but less is known in the context of children’s mental disorders.Objectives We estimated parental income and employment trajectories associated with a child’s mental dis...

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Main Authors: Natalie C Momen, Oleguer Plana-Ripoll, Christian Hakulinen, Marko Elovainio, Petri Böckerman, Kaisla Komulainen, Ripsa Niemi, Mai Gutvilig
Format: Article
Language:English
Published: BMJ Publishing Group 2025-06-01
Series:BMJ Mental Health
Online Access:https://mentalhealth.bmj.com/content/28/1/e301701.full
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author Natalie C Momen
Oleguer Plana-Ripoll
Christian Hakulinen
Marko Elovainio
Petri Böckerman
Kaisla Komulainen
Ripsa Niemi
Mai Gutvilig
author_facet Natalie C Momen
Oleguer Plana-Ripoll
Christian Hakulinen
Marko Elovainio
Petri Böckerman
Kaisla Komulainen
Ripsa Niemi
Mai Gutvilig
author_sort Natalie C Momen
collection DOAJ
description Background The onset of a severe physical illness of a child has been associated with earnings and employment losses among parents, but less is known in the context of children’s mental disorders.Objectives We estimated parental income and employment trajectories associated with a child’s mental disorder diagnosis in nationwide register-based cohorts from Finland and Denmark.Methods All parents whose child was diagnosed with a mental disorder (F00–F99 in ICD-10) at ages 1–25 in Finland and in Denmark during 1994–2019 were matched 1:1 to parents with a child without a mental disorder on psychiatric and sociodemographic characteristics. Generalised estimating equations were used to estimate the associations of a child’s mental disorder with parental annual income and employment outcomes from 5 years before to 5 years after the child’s diagnosis.Findings In 1994–2019, over one million parents in Finland and Denmark had at least one child diagnosed with a mental disorder at age 1–25. Parents exposed to a child’s mental disorder had consistently lower income and were more often unemployed compared with the matched unexposed parents, already 5 years before the child’s diagnosis. These differences became slightly larger over time, especially in analyses on strata involving parents whose child was diagnosed at a younger age. However, there was no consistent evidence of a change in parental annual income or employment around the time of their child’s diagnosis.Conclusions Our analysis shows that even in countries with strong welfare systems, a younger child’s mental disorder may contribute to widening socioeconomic inequity among families. However, the inequity in children’s mental health appears to primarily exist prior to, rather than in response to, a child’s mental disorder.Clinical implications Clinical and policy efforts should prioritise addressing pre-existing socioeconomic vulnerabilities for effective primary prevention of children’s mental disorders.
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spelling doaj-art-9c06a7606e2c48aba87b16c115b9c2bd2025-08-20T02:08:38ZengBMJ Publishing GroupBMJ Mental Health2755-97342025-06-0128110.1136/bmjment-2025-301701Association of a child’s mental disorder with parental income and employment: analysis of nationwide register-based cohorts in Finland and DenmarkNatalie C Momen0Oleguer Plana-Ripoll1Christian Hakulinen2Marko Elovainio3Petri Böckerman4Kaisla Komulainen5Ripsa Niemi6Mai Gutvilig7Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, DenmarkDepartment of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, DenmarkDepartment of Psychology, Faculty of Medicine, University of Helsinki, Helsinki, FinlandDepartment of Psychology, Faculty of Medicine, University of Helsinki, Helsinki, FinlandSchool of Business and Economics, University of Jyväskylä, Jyväskylä, FinlandDepartment of Psychology, Faculty of Medicine, University of Helsinki, Helsinki, FinlandDepartment of Psychology, Faculty of Medicine, University of Helsinki, Helsinki, FinlandDepartment of Psychology, Faculty of Medicine, University of Helsinki, Helsinki, FinlandBackground The onset of a severe physical illness of a child has been associated with earnings and employment losses among parents, but less is known in the context of children’s mental disorders.Objectives We estimated parental income and employment trajectories associated with a child’s mental disorder diagnosis in nationwide register-based cohorts from Finland and Denmark.Methods All parents whose child was diagnosed with a mental disorder (F00–F99 in ICD-10) at ages 1–25 in Finland and in Denmark during 1994–2019 were matched 1:1 to parents with a child without a mental disorder on psychiatric and sociodemographic characteristics. Generalised estimating equations were used to estimate the associations of a child’s mental disorder with parental annual income and employment outcomes from 5 years before to 5 years after the child’s diagnosis.Findings In 1994–2019, over one million parents in Finland and Denmark had at least one child diagnosed with a mental disorder at age 1–25. Parents exposed to a child’s mental disorder had consistently lower income and were more often unemployed compared with the matched unexposed parents, already 5 years before the child’s diagnosis. These differences became slightly larger over time, especially in analyses on strata involving parents whose child was diagnosed at a younger age. However, there was no consistent evidence of a change in parental annual income or employment around the time of their child’s diagnosis.Conclusions Our analysis shows that even in countries with strong welfare systems, a younger child’s mental disorder may contribute to widening socioeconomic inequity among families. However, the inequity in children’s mental health appears to primarily exist prior to, rather than in response to, a child’s mental disorder.Clinical implications Clinical and policy efforts should prioritise addressing pre-existing socioeconomic vulnerabilities for effective primary prevention of children’s mental disorders.https://mentalhealth.bmj.com/content/28/1/e301701.full
spellingShingle Natalie C Momen
Oleguer Plana-Ripoll
Christian Hakulinen
Marko Elovainio
Petri Böckerman
Kaisla Komulainen
Ripsa Niemi
Mai Gutvilig
Association of a child’s mental disorder with parental income and employment: analysis of nationwide register-based cohorts in Finland and Denmark
BMJ Mental Health
title Association of a child’s mental disorder with parental income and employment: analysis of nationwide register-based cohorts in Finland and Denmark
title_full Association of a child’s mental disorder with parental income and employment: analysis of nationwide register-based cohorts in Finland and Denmark
title_fullStr Association of a child’s mental disorder with parental income and employment: analysis of nationwide register-based cohorts in Finland and Denmark
title_full_unstemmed Association of a child’s mental disorder with parental income and employment: analysis of nationwide register-based cohorts in Finland and Denmark
title_short Association of a child’s mental disorder with parental income and employment: analysis of nationwide register-based cohorts in Finland and Denmark
title_sort association of a child s mental disorder with parental income and employment analysis of nationwide register based cohorts in finland and denmark
url https://mentalhealth.bmj.com/content/28/1/e301701.full
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