Early institutional care linked to shorter life expectancy decades later

A long-term study of individuals in Zurich showed that infants raised in early child care institutions in the 1950s had a much lower life expectancy than the general population. For the first time, the study provides strong evidence that early deprivation of affection and stimulation has serious consequences across the lifespan.

Children growing up in child care institutions in the 1950s were well cared for physically and medically, but were deprived of the reliable affection and stimulating experiences of childhood. To protect against infections and infant mortality, babies were kept largely isolated, spending most of their time alone in their cribs and having less than an hour of interaction with caregivers per day. Psychologist Patricia Lannon says, “The effects of this early childhood psychosocial deprivation are so damaging that they reduce life expectancy significantly more than well-known health risks such as smoking.” He, together with a team from the Marie Mayerhofer Institute for the Child (MMI), an affiliated institute of the University of Zurich (UZH), and the University Children’s Hospital Zurich, have examined the effects of early childhood placement in child care facilities in a population-based study.

Higher risk of mortality and shorter lifespan at younger ages

Researchers analyzed mortality data from 431 individuals living in child care institutions in Zurich between 1958 and 1961 and compared it with a group of 399 individuals from the general population who were born in the same period and region but grew up in the same families. Thus, data from a total of 830 individuals was examined and analyzed. The study’s findings are shocking: Over a period of 60 years, individuals who grew up in child care institutions had a 48% higher risk of mortality than the comparison group – their life expectancy was reduced by about 12 years on average. Deaths before age 40 nearly doubled in the group of institutionalized individuals, although the cause of death was often unknown.

The study’s findings show how important an affectionate and stimulating environment is in the first years of life. “They play an important role in the development of self-regulation and thus also in coping with emotions and stress in later life,” explains Lannon. “If they are missing, it often leads to risky and health-damaging behavior and results in increased mortality,” she says.

A chapter of Switzerland’s history subject to critical review

In Switzerland, it was common practice to place infants and children in care institutions until the 20th century, often due to social norms and decisions of government officials. Children of unmarried or very young mothers – single motherhood was not considered an acceptable family structure at the time – and children of migrant worker families were particularly at risk of being placed in care institutions. This practice was part of a system of “compulsory social measures and placement” that also included indentured child labor, forced adoption, and compulsory sterilization, and today it is part of Switzerland’s ongoing efforts to critically re-evaluate its history and work toward social reckoning.

Unique long-term data reveals lifelong outcomes

To date, relatively little is known about old child care institutions, because many individuals were so young when they lived there that they did not later remember the experience. While efforts to consider historical injustices often rely heavily on the testimony of contemporary witnesses, the present study complements this historical understanding by adding a unique long-term perspective into late adulthood: data on all children in child care institutions in Zurich were already being systematically collected since the late 1950s. This makes it possible to track their growth and health throughout their lifetime. Furthermore, since most infants were institutionalized soon after birth and their birth weight did not differ from a comparison group in the general population, harmful effects prior to institutionalization could be largely ruled out.

The historical circumstances provide a methodologically unique starting point for meaningfully examining the individual effects of institutional care during infancy under psychosocial deprivation. The findings express the tremendous suffering caused by lack of affection and stimulation in childhood. At the same time, they have global relevance as millions of children around the world are growing up in similar conditions in orphanages and other care institutions.

Background: Coming to terms with the past in Switzerland

The long-term study by the Marie Mayerhofer Children’s Institute was initiated by the Swiss Federal Council as part of the “Welfare and Coercion” national research program (NRP 76) of the Swiss National Science Foundation and makes an important contribution to the scholarly reassessment of compulsory social measures and placement in Switzerland.

The city of Zurich admits injustice

The City of Zurich appreciates the contribution that the study’s findings have made to further research and to tackling this dark chapter in Switzerland’s history. It is very important for the City Council to also acknowledge the injustice committed by the Zurich city authorities. In addition to critically reviewing the history of mandatory social measures and appointments, this acceptance also includes an official apology to victims and the establishment of a communal solidarity contribution fund.