Background Single health risk behaviours are negatively associated with educational outcomes, but any relationship between multipe risk behaviours (MRB) and educational attainment has not been explored. We assessed the extent to which simultaneous engagement in MRB during adolescence is associated with examination performance at age 16 years.
Methods Data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a population based birth cohort study of children born in England between 1991 and 1992 were used in linear and logistic regression analyses. We estimated the association between the total number of a wide range of health risk behaviours (including tobacco smoking, hazardous alcohol use and TV viewing) ranging from 0 to 13 behaviours, and educational attainment. The outcomes were: capped General Certificate of Secondary Education (GCSE) score and odds of attaining five or more GCSEs at grades A*-C. Multiple imputation was used to account for missing data.
Results We found that engagement in MRB was strongly associated with poorer educational attainment and each additional risk equated to a one grade reduction in capped GCSE score or a reduced odds of attaining five or more A*-C grades of 23%. The average cohort member engaged in 3 MRB and would therefore have an associated reduction in their GCSE examinations equivalent to three grades in one examination, or reduced odds of attaining five or more A*-C grades of 69%.
Conclusion Our findings show for the first time that engagement in a greater number of MRB during adolescence is strongly associated with poorer educational attainment at age 16 years. Preventing MRB could improve educational attainment and thereby directly and indirectly improve longer term health outcomes.
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