Umeå University's logo

umu.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Growing up with poor health and managing school: Studies on ill health and young people's educational achievements
Umeå University, Faculty of Social Sciences, Department of Social Work.ORCID iD: 0000-0001-6008-2296
2022 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim and objectives: The overall aim of this thesis was to empirically investigate consequences of poor health for children’s educational outcomes in Sweden. A central tenet is that health problems impact not only the afflicted individual but also people in their social and emotional proximity, in particular immediate family members. More specific objectives were to study: 1. The relationship between multiple clinically diagnosed mental disorders and children’s educational achievements in Sweden. 2. The bidirectional relationship between mental health problems and academic performance among Swedish adolescents, as well as heterogeneous patterns associated with gender and socioeconomic groups. 3. The effects of parental somatic and psychiatric health problems on the probability of youths leaving upper secondary education before completion in Sweden and potential gender differences in these effects. 4. The relationship between having a sibling with health problems and a healthy sibling’s school grades in the final year of compulsory education in Sweden and how socioeconomic background modifies this relationship.

Theoretical framework: Key concepts applied in the thesis are health and illness. The ability to perform things in life, the ability to act, determines whether a person is healthy or ill. Illness (or poor health, treated as a synonymous term) entails a reduced ability to act in relation to one’s life situation and its demands. Family is viewed from a systems theory perspective. Poor health of a parent reduces his or her ability to maintain regular roles, which may require reorganisation of the family system. Siblings’ health problems can affect other children in the family by inducing concerns and occupying and diverting parents’ time and attention. All of this could be psychosocially stressful in many ways, not least for children in the family and their ability in relation to schooling.

Data and methods: The research objectives were addressed by utilising social and medical microdata from Swedish administrative registers covering the entire population in Sweden. Data pertaining to different populations, collectively covering the period from 1987 to 2017, were used in four studies designated Studies I–IV. Educational achievement was measured in terms of teacher-assigned school grades awarded by the end of compulsory school and in upper secondary school, as well as completion (or non-completion) of an upper secondary education. Poor health was measured through data on outpatient visits to specialist healthcare facilities, psychotropic drug prescriptions and admissions/discharges from Swedish hospitals. Socioeconomic background was measured by parental level of education. The data were analysed by fitting linear and logistic regression models as well as cross-lagged path models.

Results and conclusions: Empirical results of Study I showed that specific diagnosed mental disorders have varying, largely disadvantageous, associations with educational achievements of students that differ between boys and girls. Documentation of this in Sweden adds to evidence that mental disorders have a negative overall association with educational achievement, despite substantial variation in support and educational systems across countries. The results of Study II provided no support for a bidirectional relationship between mental health and academic performance of students aged 15-16 to 18-19 years. However, they support a unidirectional relationship, as a negative relationship was found between school grades at graduation from compulsory school and rates of subsequent psychotropic medication use in upper secondary school. The relationship was equal in size for both boys and girls but mainly among adolescents with the highest educated parents.

Study III showed that having a mother or a father with psychiatric, but not somatic, illness that necessitated hospitalisation after completing compulsory schooling was associated with an increased probability of leaving upper secondary school before completion. No significant gender-based differences in this were found. Results presented in Study IV showed that having one or more siblings with health problems that necessitated recurrent hospitalisations was associated with lower grades. Children with ill siblings were also less likely to be eligible for an upper secondary education compared to children whose siblings did not have poor health. Socioeconomic background did not affect this educational disadvantage.

Results presented in this thesis clearly corroborate the importance of health for children’s education. Children’s educational achievements at the end of compulsory school are inversely related to mental health problems in their adolescence. Thus, academic competence may have positive effects on certain aspects of young people’s mental health, which underscores the importance of promoting opportunities for youth to do as well as they can in school. The reciprocal aspect of the relationship between mental health and academic performance among school-aged children remains an important issue that requires further investigation. However, health is not just an individual issue; parents’ and siblings’ health problems can affect children and have negative ‘spillover’ effects on their schooling and educational achievements. This underlines the importance of a psychosocial perspective when identifying children’s difficulties in school. Taken together, health, and thus the school’s student health task, is highly associated with academic achievement and schools’ pedagogical responsibilities.

Place, publisher, year, edition, pages
Umeå: Umeå Universitet , 2022. , p. 66
Series
Studier i socialt arbete vid Umeå universitet : avhandlings- och skriftserie, ISSN 0283-300X ; 99
Keywords [en]
Educational acchievements, Health, Bidirectionality, Family, Parents, Siblings, Register data
National Category
Social Work
Research subject
Sociology; Psychiatry; Public health
Identifiers
URN: urn:nbn:se:umu:diva-192131ISBN: 978-91-7855-732-5 (print)OAI: oai:DiVA.org:umu-192131DiVA, id: diva2:1634373
Public defence
2022-03-04, UB.A.210, Lindellhallen 1, Umeå, 10:00 (English)
Opponent
Supervisors
Available from: 2022-02-11 Created: 2022-02-02 Last updated: 2024-07-02Bibliographically approved
List of papers
1. Associations between children’s diagnosed mental disorders and educational achievements in Sweden
Open this publication in new window or tab >>Associations between children’s diagnosed mental disorders and educational achievements in Sweden
2022 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 50, no 8, p. 1140-1147Article in journal (Other academic) Published
Abstract [en]

Aims: To examine associations between multiple clinically diagnosed mental disorders among children in Sweden and educational achievements at the end of ninth grade.

Methods: Data from Swedish administrative registers were utilised. Diagnoses of specific mental disorders (unipolar depression, mood, anxiety, obsessive compulsive, eating, attention deficit hyperactivity disorder) were used as exposure variables. Educational achievements were assessed in terms of teacher-assigned school grades and eligibility for upper secondary education. The sample comprised 266,664 individuals (49% females) born in 2000 to 2002 who were alive and resident in Sweden in 2017. Exposed and unexposed individuals were compared in terms of outcome variables by fitting linear and logistic regression models.

Results: The results revealed negative associations between all the examined mental disorders and educational achievements, except for positive associations between eating disorders and grades among female students. Attention deficit hyperactivity disorder was the most strongly associated disorder in terms of non-successful completion of compulsory education, among both male and female students (odds ratio (OR): 3.58 (95% confidence interval (CI), 3.42 to 3.74) and 4.31 (95% CI, 4.07 to 4.57), respectively). This was followed by unipolar depression among males (OR: 2.92 (95% CI, 2.60 to 3.28)) and anxiety disorder among females (OR: 2.68 (95% CI, 2.49 to 2.88)). Obsessive compulsive disorder had the weakest negative association with educational achievements among both males (OR: 1.48 (95% CI, 1.01 to 2.17)) and females (OR: 1.38 (95% CI, 1.11 to 1.72)).

Conclusions: Specific diagnosed mental disorders have varying, largely disadvantageous, associations with educational achievements of students in Sweden that differ between males and females.

Place, publisher, year, edition, pages
Sage Publications, 2022
Keywords
Mental disorders, educational achievement, register data, Sweden, sex differences
National Category
Social Work
Identifiers
urn:nbn:se:umu:diva-192125 (URN)10.1177/14034948221089056 (DOI)000783876500001 ()35416111 (PubMedID)2-s2.0-85129236583 (Scopus ID)
Funder
Swedish Research CouncilRiksbankens Jubileumsfond
Note

Originally included in thesis in manuscript form. 

Available from: 2022-02-02 Created: 2022-02-02 Last updated: 2023-03-23Bibliographically approved
2. Psychotropic medication use and academic performance in adolescence: A cross-lagged path analysis
Open this publication in new window or tab >>Psychotropic medication use and academic performance in adolescence: A cross-lagged path analysis
2021 (English)In: Journal of Adolescence, ISSN 0140-1971, E-ISSN 1095-9254, Vol. 91, p. 25-34Article in journal (Refereed) Published
Abstract [en]

Introduction: The study investigated the directionality of associations between mental health problems and school grades across two timepoints (T1 and T2) during mid to late adolescence; inschool year 9 (ages 15–16) and school year 12 (ages 17–18). The study also investigated variation in the associations as a function of gender and across socioeconomic groups.

Methods: Longitudinal data from several Swedish administrative registers were utilised. Information on prescribed psychotropic drugs was used as a proxy for mental health problems, and teacher-assigned school grades were used to measure academic performance. The study sample comprised 85 186 individuals (50.7% girls) born in 1991 who were alive and resident in Sweden in 2010. Directions of associations were analysed by estimating a series of cross-lagged path models.

Results: The model with the best fit to data showed that higher school grades at T1 were associated with relatively lower rates of mental health problems by T2, for both boys and girls, mainlyi n socioeconomic groups with the highest educated parents. This association was equal in size across all of the socioeconomic groups that were explored.

Conclusions: Performing well in school is equally important for boys’ and girls’ subsequent mental health, but only among adolescents in socioeconomic groups with the highest educated parents. The results underscore the importance of promoting opportunities for youth to do as well as theycan in school.

Place, publisher, year, edition, pages
Elsevier, 2021
Keywords
Mental health, Academic performance, Cross-lagged panel analysis, Bidirectional associations, Gender differences, Socioeconomic background
National Category
Social Work
Identifiers
urn:nbn:se:umu:diva-186299 (URN)10.1016/j.adolescence.2021.07.003 (DOI)000685543000003 ()34298339 (PubMedID)2-s2.0-85110755387 (Scopus ID)
Funder
Swedish Research Council, 2014-1992Marianne and Marcus Wallenberg Foundation, 2014.0154
Available from: 2021-07-21 Created: 2021-07-21 Last updated: 2023-09-05Bibliographically approved
3. Parental Illness and Young People's Education
Open this publication in new window or tab >>Parental Illness and Young People's Education
2020 (English)In: Child Indicators Research, ISSN 1874-897X, E-ISSN 1874-8988, Vol. 13, no 6, p. 2069-2091Article in journal (Refereed) Published
Abstract [en]

The purpose of the present study was to investigate the effects of parental health problems on the probability of youths leaving upper secondary education before completion in Sweden, and to investigate potential gender differences in these effects. Medical and social microdata from Swedish administrative registers were used. The study population consisted of individuals born between 1987 and 1990 (N = 398,748) who were still alive and residing in Sweden in 2010. We employed a quasi-experimental pre-test post-test study design. Logistic regression was used to analyse the relationships between indicators of parental illness and young people's early school leaving in relation to health and sociodemographic confounders. Having had a mother or father with psychiatric, but not somatic, illness that necessitated hospitalisation after completing compulsory schooling was significantly associated with an increased probability of leaving upper secondary education. We found no significant gender-specific interaction effects. The existence of these effects in Sweden, a country with an extensive institutional welfare system, suggests that similar but more pronounced effects may exist in regions lacking such systems.

Place, publisher, year, edition, pages
Springer, 2020
Keywords
Parental health, Academic achievement, Early school leaving, Registry data, Sweden
National Category
Social Work
Identifiers
urn:nbn:se:umu:diva-169551 (URN)10.1007/s12187-020-09731-x (DOI)000524209800001 ()2-s2.0-85084658947 (Scopus ID)
Funder
Swedish Research Council, 2014-1992Marianne and Marcus Wallenberg Foundation, 2014.0154
Available from: 2020-04-06 Created: 2020-04-06 Last updated: 2022-02-02Bibliographically approved
4. Sibling Ill-Health and Children's Educational Outcomes
Open this publication in new window or tab >>Sibling Ill-Health and Children's Educational Outcomes
2020 (English)In: Journal of School Health, ISSN 0022-4391, E-ISSN 1746-1561, Vol. 90, no 5, p. 407-414Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The presence of health problems in a child is known to be negatively associated with later academic achievement, but less is known about the educational outcomes for siblings of children in poor health. The study investigated how having a sibling with health problems affects a healthy sibling’s academic achievement.

METHODS: We utilized medical and social microdata from Swedish administrative population registers. Our sample consisted of N = 115 106 individuals (51.3% boys) born in 1990 in Sweden. We compared children with ill siblings to children whose siblings did not have poor health. Siblings’ hospital admissions and the academic achievements of the healthy sibling during their final year of compulsory education (at the age of 15-16) were analyzed using linear and logistic regression in relation to individual health- and family-related confounders.

RESULTS: Sibling hospitalization was significantly associated with lower overall grade points (b = –10.73, p < .001) and an increased odds ratio (OR) of ineligibility for upper secondary education (OR = 1.42, 95% CI = 1.31-1.52, p < .001).

CONCLUSIONS: School and health personnel should also consider the needs of healthy siblings during their work with children in poor health, because they too can be disadvantaged.

Place, publisher, year, edition, pages
John Wiley & Sons, 2020
National Category
Social Work
Identifiers
urn:nbn:se:umu:diva-166715 (URN)10.1111/josh.12887 (DOI)000516651300001 ()32105351 (PubMedID)2-s2.0-85080107441 (Scopus ID)
Funder
Swedish Research Council, Dnr.2014-1992Marianne and Marcus Wallenberg Foundation, 2014.0154
Available from: 2019-12-20 Created: 2019-12-20 Last updated: 2023-03-24Bibliographically approved

Open Access in DiVA

Kappa(682 kB)1570 downloads
File information
File name FULLTEXT01.pdfFile size 682 kBChecksum SHA-512
83bd3ba391005b9a43bc472d4f5ed40f6d6f50e8747c96103e06325c326cbcea07488a45b4c400eb399506fe3a1cbe237ea70633bd375c6ab3dc0b1a3846aca6
Type fulltextMimetype application/pdf
Spikblad(105 kB)117 downloads
File information
File name FULLTEXT02.pdfFile size 105 kBChecksum SHA-512
a4dcf575932ed4e30e123868f05ce3081f0bfabcd013019c6a9314522dffbbd8e97bfb6810601f0b256d948423bcd20462e211bdd71701528db48b32d337bbd7
Type fulltextMimetype application/pdf

Authority records

Bortes, Cristian

Search in DiVA

By author/editor
Bortes, Cristian
By organisation
Department of Social Work
Social Work

Search outside of DiVA

GoogleGoogle Scholar
Total: 1690 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

isbn
urn-nbn

Altmetric score

isbn
urn-nbn
Total: 2559 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf