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Published in: BMC Public Health 1/2018

Open Access 01-12-2018 | Research article

The impact of completing upper secondary education - a multi-state model for work, education and health in young men

Authors: Rune Hoff, Karina Corbett, Ingrid S. Mehlum, Ferdinand A. Mohn, Petter Kristensen, Therese N. Hanvold, Jon M. Gran

Published in: BMC Public Health | Issue 1/2018

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Abstract

Background

Completing upper secondary education is associated with higher work participation and less health-related absence from work. Although these outcomes are closely interrelated, most studies focus on single outcomes, using cross-sectional designs or short follow-up periods. As such, there is limited knowledge of the long-term outcomes, and how paths for completers and non-completers unfold over time. In this paper, we use multi-state models for time-to-event data to assess the long-term effects of completing upper secondary education on employment, tertiary education, sick leave, and disability pension over twelve and a half years for young men.

Methods

Baseline covariates and twelve and a half years of follow-up data on employment, tertiary education, sick leave and disability pension were obtained from national registries for all males born in Norway between 1971 and 1976 (n =184951). The effects of completing upper secondary education (by age 23) were analysed in a multi-state framework, adjusting for both individual and family level confounders. All analyses were done separately for general studies and vocational tracks.

Results

Completers do better on a range of outcomes compared to non-completers, for both fields of upper secondary education, but effects of completion change over time. The largest changes are for tertiary education and work, with the probability of work increasing reciprocally to the probability of education. Vocational students are quicker to transfer to the labour market, but tend to have more unemployment, sick leave and disability, and the absolute effects of completion on these outcomes are largest for vocational tracks. However, the relative effects of completion are larger for general studies.

Conclusion

Completing upper secondary education increases long-term work participation and lowers health-related absence for young men, but effects diminish over time. Studies that have used shorter follow-up periods could be overstating the negative effects of dropout on labour market participation. Multi-state models are well suited to analyse data on work, education and health-related absence, and can be useful in understanding the dynamic aspects of these outcomes.
Literature
2.
go back to reference De Ridder KA, Pape K, Johnsen R, Westin S, Holmen TL, Bjørngaard 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 Commun Health. 2012; 66(11):995–1000.CrossRef De Ridder KA, Pape K, Johnsen R, Westin S, Holmen TL, Bjørngaard 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 Commun Health. 2012; 66(11):995–1000.CrossRef
3.
go back to reference De Ridder KA, Pape K, Cuypers K, Johnsen R, Holmen TL, Westin S, et al. High school dropout and long-term sickness and disability in young adulthood: a prospective propensity score stratified cohort study (the Young-HUNT study). BMC Public Health. 2013; 13(1):941.CrossRefPubMedPubMedCentral De Ridder KA, Pape K, Cuypers K, Johnsen R, Holmen TL, Westin S, et al. High school dropout and long-term sickness and disability in young adulthood: a prospective propensity score stratified cohort study (the Young-HUNT study). BMC Public Health. 2013; 13(1):941.CrossRefPubMedPubMedCentral
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):533–43.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):533–43.CrossRefPubMed
6.
go back to reference McCaul EJ, Donaldson Jr GA, Coladarci T, Davis WE. Consequences of dropping out of school: Findings from high school and beyond. J Educ Res. 1992; 85(4):198–207.CrossRef McCaul EJ, Donaldson Jr GA, Coladarci T, Davis WE. Consequences of dropping out of school: Findings from high school and beyond. J Educ Res. 1992; 85(4):198–207.CrossRef
8.
go back to reference Freudenberg N, Ruglis J. Reframing School Dropout as a Public Health Issue. Preventing Chronic Disease: Public Health Research, Practice, and Policy: Centers for Disease Control and Prevention; 2007. https://eric.ed.gov/?id=ED499412. Accessed 21 Mar 2018. Freudenberg N, Ruglis J. Reframing School Dropout as a Public Health Issue. Preventing Chronic Disease: Public Health Research, Practice, and Policy: Centers for Disease Control and Prevention; 2007. https://​eric.​ed.​gov/​?​id=​ED499412. Accessed 21 Mar 2018.
9.
go back to reference Jimerson S, Egeland B, Sroufe LA, Carlson B. A prospective longitudinal study of high school dropouts examining multiple predictors across development. J Educ Psychol. 2000; 38(6):525–49. Jimerson S, Egeland B, Sroufe LA, Carlson B. A prospective longitudinal study of high school dropouts examining multiple predictors across development. J Educ Psychol. 2000; 38(6):525–49.
10.
go back to reference Bowers AJ, Sprott R, Taff SA. Do we know who will drop out? A review of the predictors of dropping out of high school: Precision, sensitivity, and specificity. High Sch J. 2012; 96(2):77–100.CrossRef Bowers AJ, Sprott R, Taff SA. Do we know who will drop out? A review of the predictors of dropping out of high school: Precision, sensitivity, and specificity. High Sch J. 2012; 96(2):77–100.CrossRef
11.
go back to reference Kessler RC, Foster CL, Saunders WB, Stang PE. Social consequences of psychiatric disorders, I: Educational attainment. Am J Psychiatry. 1995; 152(7):1026–32.CrossRefPubMed Kessler RC, Foster CL, Saunders WB, Stang PE. Social consequences of psychiatric disorders, I: Educational attainment. Am J Psychiatry. 1995; 152(7):1026–32.CrossRefPubMed
12.
go back to reference Melkevik O, Nilsen W, Evensen M, Reneflot A, Mykletun A. Internalizing disorders as risk factors for early school leaving: a systematic review. Adolescent Res Rev. 2016; 1(3):245–55.CrossRef Melkevik O, Nilsen W, Evensen M, Reneflot A, Mykletun A. Internalizing disorders as risk factors for early school leaving: a systematic review. Adolescent Res Rev. 2016; 1(3):245–55.CrossRef
13.
go back to reference Melkevik O, Hauge LJ, Bendtsen P, Reneflot A, Mykletun A, Aarø LE. Associations between delayed completion of high school and educational attainment and symptom levels of anxiety and depression in adulthood. BMC Psychiatry. 2016; 16(1):64.CrossRefPubMedPubMedCentral Melkevik O, Hauge LJ, Bendtsen P, Reneflot A, Mykletun A, Aarø LE. Associations between delayed completion of high school and educational attainment and symptom levels of anxiety and depression in adulthood. BMC Psychiatry. 2016; 16(1):64.CrossRefPubMedPubMedCentral
14.
go back to reference Mojtabai R, Stuart EA, Hwang I, Eaton WW, Sampson N, Kessler RC. Long-term effects of mental disorders on educational attainment in the National Comorbidity Survey ten-year follow-up. Soc Psychiatry Psychiatr Epidemiol. 2015; 50(10):1577–91.CrossRefPubMedPubMedCentral Mojtabai R, Stuart EA, Hwang I, Eaton WW, Sampson N, Kessler RC. Long-term effects of mental disorders on educational attainment in the National Comorbidity Survey ten-year follow-up. Soc Psychiatry Psychiatr Epidemiol. 2015; 50(10):1577–91.CrossRefPubMedPubMedCentral
15.
go back to reference von Simson K. Explaining upper secondary school dropout: new evidence on the role of local labor markets. Empir Econ. 2015; 48(4):1419–44.CrossRef von Simson K. Explaining upper secondary school dropout: new evidence on the role of local labor markets. Empir Econ. 2015; 48(4):1419–44.CrossRef
16.
go back to reference Plomin R, Deary IJ. Genetics and intelligence differences: five special findings. Mol Psychiatry. 2015; 20(1):98–108.CrossRefPubMed Plomin R, Deary IJ. Genetics and intelligence differences: five special findings. Mol Psychiatry. 2015; 20(1):98–108.CrossRefPubMed
17.
go back to reference Kristensen P, Gravseth HM, Bjerkedal T. Educational attainment of Norwegian men: influence of parental and early individual characteristics. J Biosoc Sci. 2009; 41(6):799–814.CrossRefPubMed Kristensen P, Gravseth HM, Bjerkedal T. Educational attainment of Norwegian men: influence of parental and early individual characteristics. J Biosoc Sci. 2009; 41(6):799–814.CrossRefPubMed
18.
go back to reference Gran JM, Lie SA, Øyeflaten I, Borgan Ø, Aalen OO. Causal inference in multi-state models–sickness absence and work for 1145 participants after work rehabilitation. BMC Public Health. 2015; 15(1):1.CrossRef Gran JM, Lie SA, Øyeflaten I, Borgan Ø, Aalen OO. Causal inference in multi-state models–sickness absence and work for 1145 participants after work rehabilitation. BMC Public Health. 2015; 15(1):1.CrossRef
19.
go back to reference Lie SA, Eriksen HR, Ursin H, Hagen EM. A multi-state model for sick-leave data applied to a randomized control trial study of low back pain. Scand J of Public Health. 2008; 36(3):279–83.CrossRef Lie SA, Eriksen HR, Ursin H, Hagen EM. A multi-state model for sick-leave data applied to a randomized control trial study of low back pain. Scand J of Public Health. 2008; 36(3):279–83.CrossRef
20.
go back to reference Øyeflaten I, Lie SA, Ihlebæk CM, Eriksen HR. Multiple transitions in sick leave, disability benefits, and return to work.-A 4-year follow-up of patients participating in a work-related rehabilitation program. BMC Public Health. 2012; 12(1):748.CrossRefPubMedPubMedCentral Øyeflaten I, Lie SA, Ihlebæk CM, Eriksen HR. Multiple transitions in sick leave, disability benefits, and return to work.-A 4-year follow-up of patients participating in a work-related rehabilitation program. BMC Public Health. 2012; 12(1):748.CrossRefPubMedPubMedCentral
21.
go back to reference Pedersen J, Bjorner JB, Burr H, Christensen KB. Transitions between sickness absence, work, unemployment, and disability in Denmark 2004-2008. Scand J Work Environ Health. 2012; 38(6):516–26.CrossRefPubMed Pedersen J, Bjorner JB, Burr H, Christensen KB. Transitions between sickness absence, work, unemployment, and disability in Denmark 2004-2008. Scand J Work Environ Health. 2012; 38(6):516–26.CrossRefPubMed
22.
go back to reference Carlsen K, Harling H, Pedersen J, Christensen KB, Osler M. The transition between work, sickness absence and pension in a cohort of Danish colorectal cancer survivors. BMJ Open. 2013; 3(2). Carlsen K, Harling H, Pedersen J, Christensen KB, Osler M. The transition between work, sickness absence and pension in a cohort of Danish colorectal cancer survivors. BMJ Open. 2013; 3(2).
23.
go back to reference Pedersen J, Bjorner JB, Christensen KB. Visualizing Transitions between Multiple States? Illustrated by Analysis of Social Transfer Payments. J Biom Biostat. 2013; 4(5):1–5. Pedersen J, Bjorner JB, Christensen KB. Visualizing Transitions between Multiple States? Illustrated by Analysis of Social Transfer Payments. J Biom Biostat. 2013; 4(5):1–5.
24.
go back to reference Nexo M, Watt T, Pedersen J, Bonnema S, Hegedüs L, Rasmussen A, et al. Increased risk of long-term sickness absence, lower rate of return to work, and higher risk of unemployment and disability pensioning for thyroid patients: a Danish register-based cohort study. J Clin Endocrinol Metab. 2014; 99(9):3184–92.CrossRefPubMedPubMedCentral Nexo M, Watt T, Pedersen J, Bonnema S, Hegedüs L, Rasmussen A, et al. Increased risk of long-term sickness absence, lower rate of return to work, and higher risk of unemployment and disability pensioning for thyroid patients: a Danish register-based cohort study. J Clin Endocrinol Metab. 2014; 99(9):3184–92.CrossRefPubMedPubMedCentral
25.
go back to reference Aalen O, Borgan O, Gjessing H. Survival and Event History Analysis: A Process Point of View. New York: Springer; 2008.CrossRef Aalen O, Borgan O, Gjessing H. Survival and Event History Analysis: A Process Point of View. New York: Springer; 2008.CrossRef
27.
28.
go back to reference Andersen PK, Keiding N. Multi-state models for event history analysis. Stat Methods Med Res. 2002; 11(2):91–115.CrossRefPubMed Andersen PK, Keiding N. Multi-state models for event history analysis. Stat Methods Med Res. 2002; 11(2):91–115.CrossRefPubMed
29.
go back to reference Putter H, Fiocco M, Geskus R. Tutorial in biostatistics: competing risks and multi-state models. Stat Med. 2007; 26(11):2389–430.CrossRefPubMed Putter H, Fiocco M, Geskus R. Tutorial in biostatistics: competing risks and multi-state models. Stat Med. 2007; 26(11):2389–430.CrossRefPubMed
30.
go back to reference Meira-Machado LF, de Uña-Álvarez J, Cadarso-Suárez C, Andersen P. Multi-state models for the analysis of time-to-event data. Stat Methods Med Res. 2008; 18(2):195–222.CrossRefPubMedPubMedCentral Meira-Machado LF, de Uña-Álvarez J, Cadarso-Suárez C, Andersen P. Multi-state models for the analysis of time-to-event data. Stat Methods Med Res. 2008; 18(2):195–222.CrossRefPubMedPubMedCentral
31.
go back to reference Hanushek EA, Schwerdt G, Woessmann L, Zhang L. General education, vocational education, and labor-market outcomes over the lifecycle. J Hum Resour. 2017; 52(1):48–87.CrossRef Hanushek EA, Schwerdt G, Woessmann L, Zhang L. General education, vocational education, and labor-market outcomes over the lifecycle. J Hum Resour. 2017; 52(1):48–87.CrossRef
32.
go back to reference Robins JM, Finkelstein DM. Correcting for noncompliance and dependent censoring in an AIDS Clinical Trial with inverse probability of censoring weighted (IPCW) log-rank tests. Biometrics. 2000; 56(3):779–88.CrossRefPubMed Robins JM, Finkelstein DM. Correcting for noncompliance and dependent censoring in an AIDS Clinical Trial with inverse probability of censoring weighted (IPCW) log-rank tests. Biometrics. 2000; 56(3):779–88.CrossRefPubMed
33.
go back to reference Robins JM, Rotnitzky A, Zhao LP. Analysis of semiparametric regression models for repeated outcomes in the presence of missing data. J Am Stat Assoc. 1995; 90(429):106–21.CrossRef Robins JM, Rotnitzky A, Zhao LP. Analysis of semiparametric regression models for repeated outcomes in the presence of missing data. J Am Stat Assoc. 1995; 90(429):106–21.CrossRef
34.
go back to reference de Wreede LC, Fiocco M, Putter H, et al. mstate: an R package for the analysis of competing risks and multi-state models. J Stat Softw. 2011; 38(7):1–30.CrossRef de Wreede LC, Fiocco M, Putter H, et al. mstate: an R package for the analysis of competing risks and multi-state models. J Stat Softw. 2011; 38(7):1–30.CrossRef
35.
go back to reference Datta S, Satten GA. Validity of the Aalen–Johansen estimators of stage occupation probabilities and Nelson–Aalen estimators of integrated transition hazards for non-Markov models. Stat Probab Lett. 2001; 55(4):403–11.CrossRef Datta S, Satten GA. Validity of the Aalen–Johansen estimators of stage occupation probabilities and Nelson–Aalen estimators of integrated transition hazards for non-Markov models. Stat Probab Lett. 2001; 55(4):403–11.CrossRef
36.
go back to reference Curtis LH, Hammill BG, Eisenstein EL, Kramer JM, Anstrom KJ. Using inverse probability-weighted estimators in comparative effectiveness analyses with observational databases. Med Care. 2007; 45(10):103–7.CrossRef Curtis LH, Hammill BG, Eisenstein EL, Kramer JM, Anstrom KJ. Using inverse probability-weighted estimators in comparative effectiveness analyses with observational databases. Med Care. 2007; 45(10):103–7.CrossRef
38.
go back to reference Cole SR, Frangakis CE. The consistency statement in causal inference: a definition or an assumption?Epidemiology. 2009; 20(1):3–5.CrossRefPubMed Cole SR, Frangakis CE. The consistency statement in causal inference: a definition or an assumption?Epidemiology. 2009; 20(1):3–5.CrossRefPubMed
39.
40.
go back to reference Research Computing at USIT, University of Oslo, Norway. The Abel Cluster, owned by the University of Oslo and the Norwegian metacenter for High Performance Computing (NOTUR), and operated by the Department for Research Computing at USIT, the University of Oslo IT-department. 2018. http://www.hpc.uio.no. Accessed 21 Mar 2018. Research Computing at USIT, University of Oslo, Norway. The Abel Cluster, owned by the University of Oslo and the Norwegian metacenter for High Performance Computing (NOTUR), and operated by the Department for Research Computing at USIT, the University of Oslo IT-department. 2018. http://​www.​hpc.​uio.​no. Accessed 21 Mar 2018.
41.
go back to reference Deary IJ, Whalley LJ, Lemmon H, Crawford J, Starr JM. The stability of individual differences in mental ability from childhood to old age: follow-up of the 1932 Scottish mental survey. Intelligence. 2000; 28(1):49–55.CrossRef Deary IJ, Whalley LJ, Lemmon H, Crawford J, Starr JM. The stability of individual differences in mental ability from childhood to old age: follow-up of the 1932 Scottish mental survey. Intelligence. 2000; 28(1):49–55.CrossRef
42.
go back to reference Hertzog C, Schaie KW. Stability and change in adult intelligence: 1. Analysis of longitudinal covariance structures. Psychol Aging. 1986; 1(2):159–71.CrossRefPubMed Hertzog C, Schaie KW. Stability and change in adult intelligence: 1. Analysis of longitudinal covariance structures. Psychol Aging. 1986; 1(2):159–71.CrossRefPubMed
Metadata
Title
The impact of completing upper secondary education - a multi-state model for work, education and health in young men
Authors
Rune Hoff
Karina Corbett
Ingrid S. Mehlum
Ferdinand A. Mohn
Petter Kristensen
Therese N. Hanvold
Jon M. Gran
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2018
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-018-5420-y

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