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The Population Impact of Childhood Health Conditions on Dropout from Upper-Secondary Education - 25/04/18

Doi : 10.1016/j.jpeds.2018.01.034 
Janne Mikkonen, MSocSc 1, * , Heta Moustgaard, PhD 1, Hanna Remes, PhD 1, Pekka Martikainen, PhD 1, 2, 3
1 Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland 
2 Center for Health Equity Studies (CHESS), Department of Public Health Sciences, Stockholm University, Stockholm, Sweden 
3 The Max Planck Institute for Demographic Research, Rostock, Germany 

*Reprint requests: Janne Mikkonen, MSocSc, Population Research Unit, Faculty of Social Sciences, University of Helsinki, PO Box 18, FIN-00014, Finland.Population Research UnitFaculty of Social SciencesUniversity of HelsinkiPO Box 18, FIN-00014Finland

Abstract

Objectives

To quantify how large a part of educational dropout is due to adverse childhood health conditions and to estimate the risk of dropout across various physical and mental health conditions.

Study design

A registry-based cohort study was conducted on a 20% random sample of Finns born in 1988-1995 (n = 101 284) followed for school dropout at ages 17 and 21. Four broad groups of health conditions (any, somatic, mental, and injury) and 25 specific health conditions were assessed from inpatient and outpatient care records at ages 10-16 years. We estimated the immediate and more persistent risks of dropout due to health conditions and calculated population-attributable fractions to quantify the population impact of childhood health on educational dropout, while accounting for a wide array of sociodemographic confounders and comorbidity.

Results

Children with any health condition requiring inpatient or outpatient care at ages 10-16 years were more likely to be dropouts at ages 17 years (risk ratio 1.71, 95% CI 1.61-1.81) and 21 years (1.46, 1.37-1.54) following adjustment for individual and family sociodemographic factors. A total of 30% of school dropout was attributable to health conditions at age 17 years and 21% at age 21 years. Mental disorders alone had an attributable fraction of 11% at age 21 years, compared with 5% for both somatic conditions and injuries. Adjusting for the presence of mental disorders reduced the effects of somatic conditions.

Conclusions

More than one fifth of educational dropout is attributable to childhood health conditions. Early-onset mental disorders emerge as key targets in reducing dropout.

Le texte complet de cet article est disponible en PDF.

Keywords : education, child health, health selection, adolescence, population-attributable fraction, register-based, Finland

Abbreviations : PAF, RR


Plan


 Supported by the Academy of Finland (294861) and the Strategic Research Council of Finland (303615). The authors declare no conflicts of interest.
 Portions of this study were presented as a poster at the European Consortium for Sociological Research, August 31-September 2, 2017, Milan, Italy.


© 2018  The Authors. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 196 - N° C

P. 283 - mai 2018 Retour au numéro
Article précédent Article précédent
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