title: Childhood chronic health conditions and educational attainment: a social ecological approach.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, Maryland. Electronic address: SChampaloux@cdc.gov.
authors.forename: Steven W
authors.initials: SW
authors.lastname: Champaloux
authors.affiliation: Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California.
authors.forename: Deborah R
authors.initials: DR
authors.lastname: Young
mesh_terms: D000293:Adolescent; D002648:Child; D002908:Chronic Disease / Q000453:epidemiology*; D015331:Cohort Studies; D004522:Educational Status; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D016017:Odds Ratio; D012931:Social Environment; D013334:Students / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology
keywords: Chronic health conditions; Educational attainment; Social ecological approach