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Pediatrics. 2019 Jun;143(6). pii: e20182988. doi: 10.1542/peds.2018-2988. Epub 2019 May 6.

General Health and Life Satisfaction in Children With Chronic Illness.

Author information

Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois;
Avera McKennan Hospital and University Medical Center, Sioux Falls, South Dakota.
Department of Psychology, Columbian College of Arts and Sciences, The George Washington University, Washington, District of Columbia.
Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York.
Public Health Sciences, College of Medicine, Medical University of South Carolina, Charleston, South Carolina.
Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and.
Massachusetts General Hospital, Boston, Massachusetts.



To investigate children's general health and life satisfaction in the context of chronic illness.


Caregivers (n = 1113) from 3 concurrent cohort studies completed the Patient-Reported Outcomes Measurement Information System Parent-Proxy Global Health measure, which is used to assess a child's overall physical, mental, and social health, as well as the Patient-Reported Outcomes Measurement Information System Parent-Proxy Life Satisfaction measure between March 2017 and December 2017 for 1253 children aged 5 to 9 years. We harmonized demographic factors and family environmental stressors (single parent, maternal mental health, and income) to common metrics across the cohorts. To examine associations between chronic illness and children's general health and life satisfaction, we fit linear regression models with cohort fixed effects and accounted for the multilevel data structure of multiple children nested within the same family (ie, twins and other siblings) with generalized estimating equations.


Children with chronic illness had worse general health than those without illness (adjusted β = -1.20; 95% confidence interval: -2.49 to 0.09). By contrast, children with chronic illness had similar levels of life satisfaction (adjusted β = -.19; 95% confidence interval: -1.25 to 0.87). Additionally, children's psychological stress had the strongest negative association with both outcomes, even after adjusting for demographics and family environmental stressors.


Although children with chronic illness have lower parent-reported general health, their life satisfaction appears comparable with that of peers without chronic illness. With this study, we provide evidence that chronic illnesses do not preclude children from leading happy and satisfying lives.


Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

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