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Published in: BMC Public Health 1/2013

Open Access 01-12-2013 | Research article

High school dropout and long-term sickness and disability in young adulthood: a prospective propensity score stratified cohort study (the Young-HUNT study)

Authors: Karin A A De Ridder, Kristine Pape, Koenraad Cuypers, Roar Johnsen, Turid Lingaas Holmen, Steinar Westin, Johan Håkon Bjørngaard

Published in: BMC Public Health | Issue 1/2013

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Abstract

Background

High school dropout and long-term sickness absence/disability pension in young adulthood are strongly associated. We investigated whether common risk factors in adolescence may confound this association.

Methods

Data from 6612 school-attending adolescents (13–20 years old) participating in the Norwegian Young-HUNT1 Survey (1995–1997) was linked to long-term sickness absence or disability pension from age 24–29 years old, recorded in the Norwegian Labour and Welfare Organisation registers (1998–2008). We used logistic regression to estimate risk differences of sickness or disability for school dropouts versus completers, adjusting for health, health-related behaviours, psychosocial factors, school problems, and parental socioeconomic position. In addition, we stratified the regression models of sickness and disability following dropout across the quintiles of the propensity score for high school dropout.

Results

The crude absolute risk difference for long-term sickness or disability for a school dropout compared to a completer was 0.21% or 21% points (95% confidence interval (CI), 17 to 24). The adjusted risk difference was reduced to 15% points (95% CI, 12 to 19). Overall, high school dropout increased the risk for sickness or disability regardless of the risk factor level present for high school dropout.

Conclusion

High school dropouts have a strongly increased risk for sickness and disability in young adulthood across all quintiles of the propensity score for dropout, i.e. independent of own health, family and socioeconomic factors in adolescence. These findings reveal the importance of early prevention of dropout where possible, combined with increased attention to labour market integration and targeted support for those who fail to complete school.
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Literature
1.
go back to reference OECD: Sickness, disability and work: breaking the barriers. A synthesis of findings across OECD countries. 2010, Paris: OECD Publishing OECD: Sickness, disability and work: breaking the barriers. A synthesis of findings across OECD countries. 2010, Paris: OECD Publishing
2.
go back to reference School dropout and completion: International comparative studies in theory and policy. Edited by: Lamb S, Markussen E, Teese R, Polesel J, Sandberg N. 2011, Dordrecht: Springer Science+Business Media B.V School dropout and completion: International comparative studies in theory and policy. Edited by: Lamb S, Markussen E, Teese R, Polesel J, Sandberg N. 2011, Dordrecht: Springer Science+Business Media B.V
3.
go back to reference De Ridder KA, Pape K, Johnsen R, Westin S, Holmen TL, Bjorngaard JH: School dropout: a major public health challenge: a 10-year prospective study on medical and non-medical social insurance benefits in young adulthood, the Young-HUNT 1 Study (Norway). J Epidemiol Community Health. 2012, 66 (11): 995-1000. 10.1136/jech-2011-200047.CrossRefPubMed De Ridder KA, Pape K, Johnsen R, Westin S, Holmen TL, Bjorngaard JH: School dropout: a major public health challenge: a 10-year prospective study on medical and non-medical social insurance benefits in young adulthood, the Young-HUNT 1 Study (Norway). J Epidemiol Community Health. 2012, 66 (11): 995-1000. 10.1136/jech-2011-200047.CrossRefPubMed
4.
go back to reference Gravseth HM, Bjerkedal T, Irgens LM, Aalen OO, Selmer R, Kristensen P: Life course determinants for early disability pension: a follow-up of Norwegian men and women born 1967–1976. Eur J Epidemiol. 2007, 22 (8): 533-543. 10.1007/s10654-007-9139-9.CrossRefPubMed Gravseth HM, Bjerkedal T, Irgens LM, Aalen OO, Selmer R, Kristensen P: Life course determinants for early disability pension: a follow-up of Norwegian men and women born 1967–1976. Eur J Epidemiol. 2007, 22 (8): 533-543. 10.1007/s10654-007-9139-9.CrossRefPubMed
5.
go back to reference Graham H, Power C: Childhood disadvantage and health inequalities: a framework for policy based on lifecourse research. Child Care Health Dev. 2004, 30 (6): 671-678. 10.1111/j.1365-2214.2004.00457.x.CrossRefPubMed Graham H, Power C: Childhood disadvantage and health inequalities: a framework for policy based on lifecourse research. Child Care Health Dev. 2004, 30 (6): 671-678. 10.1111/j.1365-2214.2004.00457.x.CrossRefPubMed
6.
go back to reference Koivusilta LK, Rimpela AH, Rimpela M, Vikat A: Health behavior-based selection into educational tracks starts in early adolescence. Health Educ Res. 2001, 16 (2): 201-214. 10.1093/her/16.2.201.CrossRefPubMed Koivusilta LK, Rimpela AH, Rimpela M, Vikat A: Health behavior-based selection into educational tracks starts in early adolescence. Health Educ Res. 2001, 16 (2): 201-214. 10.1093/her/16.2.201.CrossRefPubMed
7.
go back to reference Huurre T, Aro H, Rahkonen O, Komulainen E: Health, lifestyle, family and school factors in adolescence: predicting adult educational level. Educ Res. 2006, 48 (1): 41-53. 10.1080/00131880500498438.CrossRef Huurre T, Aro H, Rahkonen O, Komulainen E: Health, lifestyle, family and school factors in adolescence: predicting adult educational level. Educ Res. 2006, 48 (1): 41-53. 10.1080/00131880500498438.CrossRef
8.
go back to reference Rothon C, Head J, Klineberg E, Stansfeld S: Can social support protect bullied adolescents from adverse outcomes? A prospective study on the effects of bullying on the educational achievement and mental health of adolescents at secondary schools in East London. J Adolesc. 2011, 34 (3): 579-588. 10.1016/j.adolescence.2010.02.007.CrossRefPubMedPubMedCentral Rothon C, Head J, Klineberg E, Stansfeld S: Can social support protect bullied adolescents from adverse outcomes? A prospective study on the effects of bullying on the educational achievement and mental health of adolescents at secondary schools in East London. J Adolesc. 2011, 34 (3): 579-588. 10.1016/j.adolescence.2010.02.007.CrossRefPubMedPubMedCentral
9.
go back to reference Winding TN, Nohr EA, Labriola M, Biering K, Andersen JH: Personal predictors of educational attainment after compulsory school: influence of measures of vulnerability, health, and school performance. Scand J Public Health. 2013, 41 (1): 92-101. 10.1177/1403494812467713.CrossRefPubMed Winding TN, Nohr EA, Labriola M, Biering K, Andersen JH: Personal predictors of educational attainment after compulsory school: influence of measures of vulnerability, health, and school performance. Scand J Public Health. 2013, 41 (1): 92-101. 10.1177/1403494812467713.CrossRefPubMed
10.
go back to reference Power C, Matthews S: Origins of health inequalities in a national population sample. Lancet. 1997, 350 (9091): 1584-1589. 10.1016/S0140-6736(97)07474-6.CrossRefPubMed Power C, Matthews S: Origins of health inequalities in a national population sample. Lancet. 1997, 350 (9091): 1584-1589. 10.1016/S0140-6736(97)07474-6.CrossRefPubMed
11.
go back to reference Power C, Atherton K, Strachan DP, Shepherd P, Fuller E, Davis A, Gibb I, Kumari M, Lowe G, Macfarlane GJ, et al: Life-course influences on health in British adults: effects of socio-economic position in childhood and adulthood. Int J Epidemiol. 2007, 36 (3): 532-539. 10.1093/ije/dyl310.CrossRefPubMed Power C, Atherton K, Strachan DP, Shepherd P, Fuller E, Davis A, Gibb I, Kumari M, Lowe G, Macfarlane GJ, et al: Life-course influences on health in British adults: effects of socio-economic position in childhood and adulthood. Int J Epidemiol. 2007, 36 (3): 532-539. 10.1093/ije/dyl310.CrossRefPubMed
12.
go back to reference Henderson M, Stansfeld S, Hotopf M: Self-rated health and later receipt of work-related benefits: evidence from the 1970 British Cohort Study. Psychol Med. 2013, 43 (8): 1755-1762. 10.1017/S0033291712002528.CrossRefPubMed Henderson M, Stansfeld S, Hotopf M: Self-rated health and later receipt of work-related benefits: evidence from the 1970 British Cohort Study. Psychol Med. 2013, 43 (8): 1755-1762. 10.1017/S0033291712002528.CrossRefPubMed
13.
go back to reference Pape K, Bjorngaard JH, Westin S, Holmen TL, Krokstad S: Reading and writing difficulties in adolescence and later risk of welfare dependence. A ten year follow-up, the HUNT Study, Norway. BMC Public Health. 2011, 11: 718-10.1186/1471-2458-11-718.CrossRefPubMedPubMedCentral Pape K, Bjorngaard JH, Westin S, Holmen TL, Krokstad S: Reading and writing difficulties in adolescence and later risk of welfare dependence. A ten year follow-up, the HUNT Study, Norway. BMC Public Health. 2011, 11: 718-10.1186/1471-2458-11-718.CrossRefPubMedPubMedCentral
14.
go back to reference Pape K, Bjørngaard JH, Holmen TL, Krokstad S: The welfare burden of adolescent anxiety and depression: a prospective study of 7500 young Norwegians and their families: the HUNT study. BMJ Open. 2012, 2 (6): e001942-10.1136/bmjopen-2012-001942.CrossRefPubMedPubMedCentral Pape K, Bjørngaard JH, Holmen TL, Krokstad S: The welfare burden of adolescent anxiety and depression: a prospective study of 7500 young Norwegians and their families: the HUNT study. BMJ Open. 2012, 2 (6): e001942-10.1136/bmjopen-2012-001942.CrossRefPubMedPubMedCentral
15.
go back to reference Neovius K, Neovius M, Rasmussen F: The combined effects of overweight and smoking in late adolescence on subsequent disability pension: a nationwide cohort study. Int J Obes. 2009, 34 (1): 75-82.CrossRef Neovius K, Neovius M, Rasmussen F: The combined effects of overweight and smoking in late adolescence on subsequent disability pension: a nationwide cohort study. Int J Obes. 2009, 34 (1): 75-82.CrossRef
16.
go back to reference De Ridder KAA, Pape K, Johnsen R, Holmen TL, Westin S, Bjørngaard JH: Adolescent health and high school dropout: a prospective cohort study of 9000 Norwegian adolescents (The Young-HUNT). PLoS One. 8 (9): e74954- De Ridder KAA, Pape K, Johnsen R, Holmen TL, Westin S, Bjørngaard JH: Adolescent health and high school dropout: a prospective cohort study of 9000 Norwegian adolescents (The Young-HUNT). PLoS One. 8 (9): e74954-
17.
go back to reference Kuh D, Ben-Shlomo Y, Lynch J, Hallqvist J, Power C: Life course epidemiology. J Epidemiol Community Health. 2003, 57 (10): 778-783. 10.1136/jech.57.10.778.CrossRefPubMedPubMedCentral Kuh D, Ben-Shlomo Y, Lynch J, Hallqvist J, Power C: Life course epidemiology. J Epidemiol Community Health. 2003, 57 (10): 778-783. 10.1136/jech.57.10.778.CrossRefPubMedPubMedCentral
18.
go back to reference Najman JM: Commentary: general or cause-specific factors in explanations of class inequalities in health. Int J Epidemiol. 2001, 30 (2): 296-297. 10.1093/ije/30.2.296.CrossRefPubMed Najman JM: Commentary: general or cause-specific factors in explanations of class inequalities in health. Int J Epidemiol. 2001, 30 (2): 296-297. 10.1093/ije/30.2.296.CrossRefPubMed
19.
go back to reference Johansson E, Leijon O, Falkstedt D, Farah A, Hemmingsson T: Educational differences in disability pension among Swedish middle-aged men: role of factors in late adolescence and work characteristics in adulthood. J Epidemiol Community Health. 2012, 66 (10): 901-907. 10.1136/jech-2011-200317.CrossRefPubMed Johansson E, Leijon O, Falkstedt D, Farah A, Hemmingsson T: Educational differences in disability pension among Swedish middle-aged men: role of factors in late adolescence and work characteristics in adulthood. J Epidemiol Community Health. 2012, 66 (10): 901-907. 10.1136/jech-2011-200317.CrossRefPubMed
20.
go back to reference Holmen TL, Bratberg G, Krokstad S, Langhammer A, Hveem K, Midthjell K, Heggland J, Holmen J: Cohort profile of the young-HUNT study, norway: a population-based study of adolescents. Int J Epidemiol. 2013, doi:10.1093/ije/dys232. Feb 4. (Epub ahead of print) Holmen TL, Bratberg G, Krokstad S, Langhammer A, Hveem K, Midthjell K, Heggland J, Holmen J: Cohort profile of the young-HUNT study, norway: a population-based study of adolescents. Int J Epidemiol. 2013, doi:10.1093/ije/dys232. Feb 4. (Epub ahead of print)
21.
go back to reference Cole TJ, Bellizzi MC, Flegal KM, Dietz WH: Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000, 320 (7244): 1240-1243. 10.1136/bmj.320.7244.1240.CrossRefPubMedPubMedCentral Cole TJ, Bellizzi MC, Flegal KM, Dietz WH: Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000, 320 (7244): 1240-1243. 10.1136/bmj.320.7244.1240.CrossRefPubMedPubMedCentral
22.
go back to reference White IR, Royston P, Wood AM: Multiple imputation using chained equations: issues and guidance for practice. Stat Med. 2011, 30 (4): 377-399. 10.1002/sim.4067.CrossRefPubMed White IR, Royston P, Wood AM: Multiple imputation using chained equations: issues and guidance for practice. Stat Med. 2011, 30 (4): 377-399. 10.1002/sim.4067.CrossRefPubMed
24.
go back to reference Katz MH: Methods for adjusting for baseline differences between treatment groups. Evaluating clinical and public health interventions: a practical guide to study design and statistics. Edited by: Katz MH. 2010, Cambridge: Cambridge University Press, 101-115. 1CrossRef Katz MH: Methods for adjusting for baseline differences between treatment groups. Evaluating clinical and public health interventions: a practical guide to study design and statistics. Edited by: Katz MH. 2010, Cambridge: Cambridge University Press, 101-115. 1CrossRef
25.
go back to reference Becker SO, Ichino A: Estimation of average treatment effects based on propensity scores. Stata J. 2002, 2 (4): 358-377. Becker SO, Ichino A: Estimation of average treatment effects based on propensity scores. Stata J. 2002, 2 (4): 358-377.
26.
go back to reference Gravseth HM, Bjerkedal T, Irgens LM, Aalen OO, Selmer R, Kristensen P: Influence of physical, mental and intellectual development on disability in young Norwegian men. Eur J Public Health. 2008, 18 (6): 650-655. 10.1093/eurpub/ckn055.CrossRefPubMed Gravseth HM, Bjerkedal T, Irgens LM, Aalen OO, Selmer R, Kristensen P: Influence of physical, mental and intellectual development on disability in young Norwegian men. Eur J Public Health. 2008, 18 (6): 650-655. 10.1093/eurpub/ckn055.CrossRefPubMed
27.
go back to reference Samuelsson A, Alexanderson K, Ropponen A, Lichtenstein P, Svedberg P: Incidence of disability pension and associations with socio-demographic factors in a Swedish twin cohort. Soc Psychiatry Psychiatr Epidemiol. 2012, 47 (12): 1999-2009. 10.1007/s00127-012-0498-5.CrossRefPubMed Samuelsson A, Alexanderson K, Ropponen A, Lichtenstein P, Svedberg P: Incidence of disability pension and associations with socio-demographic factors in a Swedish twin cohort. Soc Psychiatry Psychiatr Epidemiol. 2012, 47 (12): 1999-2009. 10.1007/s00127-012-0498-5.CrossRefPubMed
28.
go back to reference Suominen S, Gould R, Ahvenainen J, Vahtera J, Uutela A, Koskenvuo M: Sense of coherence and disability pensions. A nationwide, register based prospective population study of 2196 adult Finns. J Epidemiol Community Health. 2005, 59 (6): 455-459. 10.1136/jech.2003.019414.CrossRefPubMedPubMedCentral Suominen S, Gould R, Ahvenainen J, Vahtera J, Uutela A, Koskenvuo M: Sense of coherence and disability pensions. A nationwide, register based prospective population study of 2196 adult Finns. J Epidemiol Community Health. 2005, 59 (6): 455-459. 10.1136/jech.2003.019414.CrossRefPubMedPubMedCentral
29.
go back to reference Narusyte J, Ropponen A, Silventoinen K, Alexanderson K, Kaprio J, Samuelsson A, Svedberg P: Genetic liability to disability pension in women and men: a prospective population-based twin study. PLoS One. 2011, 6 (8): e23143-10.1371/journal.pone.0023143.CrossRefPubMedPubMedCentral Narusyte J, Ropponen A, Silventoinen K, Alexanderson K, Kaprio J, Samuelsson A, Svedberg P: Genetic liability to disability pension in women and men: a prospective population-based twin study. PLoS One. 2011, 6 (8): e23143-10.1371/journal.pone.0023143.CrossRefPubMedPubMedCentral
30.
go back to reference Pape K, Bjørngaard JH, De Ridder KAA, Westin S, Holmen TL, Krokstad S: Medical benefits in young Norwegians and their parents, and the contribution of family health and socioeconomic status. The HUNT Study, Norway. Scand J Public Health. 2013, 41 (5): 455-462. 10.1177/1403494813481645.CrossRefPubMed Pape K, Bjørngaard JH, De Ridder KAA, Westin S, Holmen TL, Krokstad S: Medical benefits in young Norwegians and their parents, and the contribution of family health and socioeconomic status. The HUNT Study, Norway. Scand J Public Health. 2013, 41 (5): 455-462. 10.1177/1403494813481645.CrossRefPubMed
31.
go back to reference Volanen S-M, Lahelma E, Silventoinen K, Suominen S: Factors contributing to sense of coherence among men and women. Eur J Public Health. 2004, 14 (3): 322-330. 10.1093/eurpub/14.3.322.CrossRefPubMed Volanen S-M, Lahelma E, Silventoinen K, Suominen S: Factors contributing to sense of coherence among men and women. Eur J Public Health. 2004, 14 (3): 322-330. 10.1093/eurpub/14.3.322.CrossRefPubMed
32.
go back to reference Henderson M, Richards M, Stansfeld S, Hotopf M: The association between childhood cognitive ability and adult long-term sickness absence in three British birth cohorts: a cohort study. BMJ Open. 2012, 2 (2): e000777-10.1136/bmjopen-2011-000777.CrossRefPubMedPubMedCentral Henderson M, Richards M, Stansfeld S, Hotopf M: The association between childhood cognitive ability and adult long-term sickness absence in three British birth cohorts: a cohort study. BMJ Open. 2012, 2 (2): e000777-10.1136/bmjopen-2011-000777.CrossRefPubMedPubMedCentral
33.
go back to reference Sitzmann T, Ely K: A meta-analysis of self-regulated learning in work-related training and educational attainment: what we know and where we need to go. Psychol Bull. 2011, 137 (3): 421-442.CrossRefPubMed Sitzmann T, Ely K: A meta-analysis of self-regulated learning in work-related training and educational attainment: what we know and where we need to go. Psychol Bull. 2011, 137 (3): 421-442.CrossRefPubMed
34.
go back to reference Christensen U, Schmidt L, Kriegbaum M, Hougaard CØ, Holstein BE: Coping with unemployment: does educational attainment make any difference?. Scand J Public Health. 2006, 34 (4): 363-370. 10.1080/14034940500489339.CrossRefPubMed Christensen U, Schmidt L, Kriegbaum M, Hougaard CØ, Holstein BE: Coping with unemployment: does educational attainment make any difference?. Scand J Public Health. 2006, 34 (4): 363-370. 10.1080/14034940500489339.CrossRefPubMed
35.
go back to reference Ackerman PL, Chamorro-Premuzic T, Furnham A: Trait complexes and academic achievement: Old and new ways of examining personality in educational contexts. Br J Educ Psychol. 2011, 81 (1): 27-40. 10.1348/000709910X522564.CrossRefPubMed Ackerman PL, Chamorro-Premuzic T, Furnham A: Trait complexes and academic achievement: Old and new ways of examining personality in educational contexts. Br J Educ Psychol. 2011, 81 (1): 27-40. 10.1348/000709910X522564.CrossRefPubMed
36.
go back to reference Westin S, Schlesselman JJ, Korper M: Long-term effects of a factory closure: unemployment and disability during ten years’ follow-up. J Clin Epidemiol. 1989, 42 (5): 435-441. 10.1016/0895-4356(89)90133-9.CrossRefPubMed Westin S, Schlesselman JJ, Korper M: Long-term effects of a factory closure: unemployment and disability during ten years’ follow-up. J Clin Epidemiol. 1989, 42 (5): 435-441. 10.1016/0895-4356(89)90133-9.CrossRefPubMed
Metadata
Title
High school dropout and long-term sickness and disability in young adulthood: a prospective propensity score stratified cohort study (the Young-HUNT study)
Authors
Karin A A De Ridder
Kristine Pape
Koenraad Cuypers
Roar Johnsen
Turid Lingaas Holmen
Steinar Westin
Johan Håkon Bjørngaard
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2013
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-13-941

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