Background School and work participation in adolescence and young adulthood are important for future health and socioeconomic status. The authors studied the association between self-rated health in adolescents, high school dropout and long-term receipt of medical and non-medical social insurance benefits in young adulthood.

Methods Self-rated health in adolescence was assessed in 8795 adolescents participating in the Norwegian Young-HUNT Study (1995–1997). Linkages to the National Education Database and the National Insurance Administration allowed identification of school dropout and receipt of long-term medical and non-medical benefits during a 10-year follow-up (1998–2007). The data were explored by descriptive statistics and by multinomial logistic regression.

Results A total of 17% was registered as being high school dropouts at age 24. The predicted 5-year risk of receiving benefits between ages 24–28 was 21% (95% CI 20% to 23%). High school dropouts had a 5-year risk of receiving benefits of 44% (95% CI 41 to 48) compared with 16% (95% CI 15 to 17) in those who completed high school (adjusted for self-rated health, parental education and sex). There was a 27% school dropout rate in adolescents who reported poor health compared with 16% in those who reported good health. The predicted 5-year risk of receiving any long-term social insurance benefits in adolescents who reported poor health was 33% (95% CI 30 to 37) compared with 20% (95% CI 19 to 21) in those who reported good health.

Conclusion The strong association between poor self-rated health in adolescence, high school dropout and reduced work integration needs attention and suggests preventive measures on an individual as well as on a societal level.