title: High school incompletion and childhood maltreatment among street-involved young people in Vancouver, Canada.
abstract: While the link between educational attainment and future health and wellness is well understood, little investigation has considered the potential impacts of distinct forms of childhood maltreatment on high school completion. In the present study, the relationship between five categories of childhood maltreatment (physical, emotional, and sexual abuse, and physical and emotional neglect) and completion of high school education were examined using the Childhood Trauma Questionnaire (CTQ). From September 2005 to May 2013, data were collected for the At-Risk Youth Study (ARYS), a cohort of street-involved young people who use illicit drugs in Vancouver, Canada. We used logistic regression to examine the relationship between childhood maltreatment and high school completion, while controlling for a range of potential confounding variables. Specifically, five separate models for each category of maltreatment and two combined models were employed to examine the relative associations between, and cumulative impact of, different forms of childhood maltreatment and educational attainment. Among 974 young people, 737 (76%) reported not completing high school. In separate multivariable analyses physical abuse, emotional abuse, physical neglect, and emotional neglect remained positively and independently associated with an incomplete high school education. In a combined multivariable model with all forms of childhood maltreatment considered together, emotional abuse (adjusted odds ratio = 2.08; 95% confidence interval: 1.51-2.86) was the only form of maltreatment that remained significantly associated with an incomplete high school education. The cumulative impact assessment indicated a moderate dose-dependent trend where the greater the number of different forms of childhood maltreatment the greater the risk of not completing a high school education. These findings point to the need for trauma-informed interventions to improve educational attainment among vulnerable young people, as well as evidence-based prevention programmes, such as the Nurse-Family Partnership, aimed at supporting at-risk families before maltreatment occurs.
authors.affiliation: Urban Health Research Initiative, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.|Interdisciplinary Studies Graduate Program, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Brittany
authors.initials: B
authors.lastname: Barker
authors.affiliation: Urban Health Research Initiative, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.|Division of AIDS, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Thomas
authors.initials: T
authors.lastname: Kerr
authors.affiliation: Urban Health Research Initiative, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.
authors.forename: Huiru
authors.initials: H
authors.lastname: Dong
authors.affiliation: Urban Health Research Initiative, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.|Division of AIDS, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Evan
authors.initials: E
authors.lastname: Wood
authors.affiliation: Urban Health Research Initiative, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.|School of Public Policy, Simon Fraser University at Harbour Centre, Vancouver, British Columbia, Canada.
authors.forename: Kora
authors.initials: K
authors.lastname: DeBeck
mesh_terms: D000293:Adolescent; D002170:Canada; D002649:Child Abuse / Q000523:psychology*; D015331:Cohort Studies; D005260:Female; D006703:Ill-Housed Persons / Q000523:psychology*; D018453:Homeless Youth / Q000523:psychology; D006801:Humans; D008297:Male; D013332:Student Dropouts / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Childhood Trauma Questionnaire; child abuse; child/adolescent mental health; education; homelessness; substance use