title: Preventive healthcare surveillance can detect emerging behavioural problems that are related to later school dropouts.
abstract: OBJECTIVE
  School dropout is a multidimensional problem with negative consequences for socio-economic status. Most interventions to reduce school dropout have been implemented in education rather than in preventive healthcare. Our goal was to determine whether measurements used in preventive healthcare surveillance enabled us to detect internalising and externalising problems in relation to later school dropouts.
  
  
  METHODS
  Using a case-control design, we compared Dutch dropouts (n = 301) and nondropouts (n = 270), who were aged 18-23 in 2008, by examining their youth healthcare, socio-medical records from birth onwards. Logistic regression models were estimated.
  
  
  RESULTS
  Young adults with externalising problems in their earlier life had 56% higher odds of dropping out compared to those without externalising problems (OR = 1.56; 95% CI: 1.02-2.37), when data were adjusted for sex, socio-economic and ethnic background and family composition. Internalising problems did not differ between the cases and controls.
  
  
  CONCLUSIONS
  Our findings suggest that early life symptoms of emerging behavioural problems, as detected by preventive healthcare surveillance, are related to later school dropout. Preventive healthcare professionals can play a role in helping to prevent school dropouts, and this study underlines that school dropout is an important preventive healthcare issue.
authors.affiliation: Department of Social Medicine, CAPHRI, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
authors.forename: Ingeborg
authors.initials: I
authors.lastname: Heetman
authors.forename: Hans
authors.initials: H
authors.lastname: Bosma
authors.forename: Gérard
authors.initials: G
authors.lastname: Kuiper
authors.forename: Frans
authors.initials: F
authors.lastname: Feron
mesh_terms: D000293:Adolescent; D001526:Behavioral Symptoms / Q000453:epidemiology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D011159:Population Surveillance; D011314:Preventive Health Services; D013332:Student Dropouts / Q000523:psychology*; D055815:Young Adult
keywords: Behaviour; Child and youth healthcare; Externalising and internalising problems; Preventive healthcare; School dropout