title: Importance of physical health and health-behaviors in adolescence for risk of dropout from secondary education in young adulthood: an 8-year prospective study.
abstract: BACKGROUND
  Education and health constitute two interlinked assets that are highly important to individuals. In Iceland, prevalence of dropout from secondary education poses a considerable problem. This 8-year prospective study assesses to what extent poor physical health and negative health-behaviors of Icelandic adolescents predict increased odds of dropout from secondary education.
  
  
  METHODS
  The sample included n = 201 Icelandic children who participated at age 15 (baseline) and again at age 23 (follow-up). Data included objective measurements of physical health and questionnaires assessing health-behaviors, education status, parental education, neighborhood characteristics, self-esteem, and depression. Independent t-tests and chi-square were used to assess differences in physical health and health-behaviors at follow-up stratified by education status. Ordinal regression models were conducted to assess whether physical health and health-behaviors at age 15 predicted increased odds of dropout from secondary education at age 23, independent of gender, parental education and psychological factors.
  
  
  RESULTS
  At age 23, 78 % of girls and 71 % of boys had completed a secondary education. Completion of a secondary education was associated with significant health benefits, especially among women. Women without a secondary education had lower fitness, more somatic complaints, higher diastolic blood pressure, less sports participation, and poorer sleep, whilst men without a secondary education watched more television. In logistic regression models somatic complaints during adolescence were associated with 1.09 (95 % CI: 1.02-1.18) higher odds of dropout from secondary education in young adulthood, independent of covariates. Health-behaviors associated with higher dropout odds included smoking (3.67, 95 % CI: 1.50-9.00), alcohol drinking (2.57, 95 % CI: 1.15-5.75), and time spent watching television (1.27, 95 % CI:1.03-1.56), which were independent of most covariates. Finally, mother's higher education was strongly associated with significantly lower dropout odds (OR 0.54, 95 % CI: 0.34-0.88) independent of father's education and psychological factors, whilst high self-esteem was independently associated with lower dropout odds (OR 0.91, 95 % CI: 0.85-0.98).
  
  
  CONCLUSIONS
  Completion of a secondary education yields substantial physical health benefits for young women, but not for men. Importantly, somatic complaints and negative health-behaviors among adolescent boys and girls adversely impact their educational outcomes later in life, and may have widespread consequences for their future prospects.
authors.affiliation: School of Education, University of Iceland, Stakkahlíð, 105, Reykjavík, Iceland. erlas@hi.is.|Landspitali-University Hospital, Eiríksgötu 5, 101, Reykjavík, Iceland. erlas@hi.is.
authors.forename: Erla
authors.initials: E
authors.lastname: Svansdottir
authors.affiliation: School of Education, University of Iceland, Stakkahlíð, 105, Reykjavík, Iceland. sarngrim@hi.is.|Center for Sport and Health Sciences, University of Iceland, Lindarbraut 4, 840, Laugarvatn, Iceland. sarngrim@hi.is.
authors.forename: Sigurbjorn A
authors.initials: SA
authors.lastname: Arngrimsson
authors.affiliation: Research Centre of Movement Science, School of Health Sciences, University of Iceland, Stapi v/Hringbraut, 101, Reykjavík, Iceland. thorasve@hi.is.
authors.forename: Thorarinn
authors.initials: T
authors.lastname: Sveinsson
authors.affiliation: School of Education, University of Iceland, Stakkahlíð, 105, Reykjavík, Iceland. erljo@hi.is.|Center for Sport and Health Sciences, University of Iceland, Lindarbraut 4, 840, Laugarvatn, Iceland. erljo@hi.is.
authors.forename: Erlingur
authors.initials: E
authors.lastname: Johannsson
mesh_terms: D000293:Adolescent; D004493:Education; D005260:Female; D006262:Health / Q000592:standards* / Q000706:statistics & numerical data; D015438:Health Behavior; D006801:Humans; D007055:Iceland; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D012649:Self Concept; D013332:Student Dropouts; D011795:Surveys and Questionnaires