Childhood chronic health conditions and educational attainment: a social ecological approach

Purpose: This study examined the association between types of chronic health conditions reported during childhood and adolescence and their impact on educational attainment. School and neighborhood environments and potential mediating factors from academic and psychosocial variables were investigated.

Methods: Using the National Longitudinal Survey of Youth-Cohort 1997, multivariate logistic regression models were fit to estimate the association between chronic health conditions and educational attainment, adjusting for confounders. Chronic health conditions were defined as a parental (1997) or participant (2002) report of a chronic health condition and classified into (1) asthma; (2) cancer, diabetes, and epilepsy; (3) heart conditions; and (4) other. Educational attainment was defined as receiving a high school diploma or Graduate Equivalency Degree by age 21, determined from self-report.

Results: Youth who reported having a chronic health condition had higher odds of low educational attainment compared with youth who did not report a condition (n = 6,795; odds ratio [OR], 1.47; 95% confidence interval [CI], 1.22-1.76). Specifically, youth with asthma (OR, 1.63; 95% CI, 1.31-2.02) and those with cancer, diabetes, or epilepsy (OR, 1.96; 95% CI, 1.13-3.37) had higher odds of low attainment. For youth who reported cancer, diabetes, or epilepsy, the variables "school absences," "repeated a grade," and "depressive symptoms" attenuated the association and were considered mediators.

Conclusions: Youth with chronic health conditions had lower educational attainment. Students with cancer, diabetes, or epilepsy who had a high number of absences, had repeated a grade, or had a high-depressive symptoms score were particularly impacted.