Childhood adversity, early school leaving and long-term social benefit use: A longitudinal mediation analysis of a population-wide study

Background
Childhood adversity has been associated with early school leaving and reliance on social benefits. In this mediation study, we disentangle the contribution of differential likelihood of and differential susceptibility to early school leaving in the association between childhood adversity and long-term use of social benefits in young adulthood.
Methods
We used nationwide register data from the Danish Life Course cohort study on individuals born between Jan 1, 1980, and Oct 2, 1987, who did not die or emigrate before age 16, with complete information on education at age 30 (n = 370,165). Individuals were assigned to one of five trajectory groups based on annual exposure to 12 adversities from age 0–15 across three dimensions. Early school leaving was defined as not completing upper secondary schooling before age 30. Long-term social benefit use was defined as receiving benefits for 52 consecutive weeks between age 30 and 35 years. Using counterfactual mediation analysis, we estimated how differential likelihood of and susceptibility to early school leaving contributed to the association between childhood adversity and long-term use of social benefits.
Results
Childhood adversity was associated with between 31 and 262 additional cases of long-term social benefit use per 1000 individuals. Between 26 % and 31 % of these additional cases were attributed to differential likelihood of early school leaving. The contribution of differential susceptibility to early school leaving ranged from negligible to 27 % across the childhood adversity groups.
Interpretation
A higher likelihood as well as a greater susceptibility to early school leaving among individuals with a history of childhood adversity, explains a substantial proportion of the additional cases of long-term social benefit use observed in these groups. Multifaceted policies and interventions are needed to address the ramifications of childhood adversity, reduce early school leaving, and limit long-term use of social benefits in the population.