Janne Mikkonen1, Heta Moustgaard2, Hanna Remes2, Pekka Martikainen3. 1. Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland. Electronic address: janne.mk.mikkonen@helsinki.fi. 2. Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland. 3. Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland; Center for Health Equity Studies (CHESS), Department of Public Health Sciences, Stockholm University, Stockholm, Sweden; The Max Planck Institute for Demographic Research, Rostock, Germany.
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.
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.
Authors: Sara Siddi; Susana Ochoa; Aida Farreny; Gildas Brébion; Frank Larøi; Jorge Cuevas-Esteban; Josep Maria Haro; Christian Stephan-Otto; Antonio Preti Journal: Int J Methods Psychiatr Res Date: 2018-09-20 Impact factor: 4.035