Labour market exits in a former out-of-home care population: A birth cohort-based sequence analysis.

Ways of exiting the labour market both reflect previous health and socioeconomic disadvantage, and shape opportunities for healthy ageing. We apply sequence analysis on data from a 1953 Stockholm birth cohort to describe typical labour market exit routes between ages 55 and 68, both in the full sample and among the subgroup of individuals with childhood experience of out-of-home care for family reasons - a population with a high prevalence of childhood adversity. Information on income is used to further characterize these routes. Based on multinomial logistic regression analysis, we examine educational attainment and gender as predictors of exit routes, and as effect modifiers in the association between out-of-home care and exit routes. The normative transition from employment to pension was the most common type of exit in both samples. Individuals clustered into two non-normative routes in the full sample (health-related benefits; early mortality) and four non-normative routes in the care-experienced sample (health-related benefits with income from work; health-related benefits without income from work; unemployment; early mortality), largely reflecting a higher degree of financial disadvantage. We furthermore show that out-of-home care is associated with higher odds of following non-normative exit routes and that higher educational attainment might have the potential to mitigate this association. No consistent differences between men and women emerged in the analyses. Altogether, this study is the first to take a person-centred and prospective approach to describe the heterogeneity in early labour market exits in a high-risk population. Future research should further explore resilience factors in this context.