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How adolescent health influences education and employment: investigating longitudinal associations and mechanisms
  1. Daniel R Hale1,
  2. Russell M Viner2
  1. 1 Department of Psychology, Heriot-Watt University, Edinburgh, UK
  2. 2 UCL Institute of Child Health, London, UK
  1. Correspondence to Dr Daniel R Hale, Heriot-Watt University, Edinburgh EH14 4AS, UK; d.hale{at}


Background Education is recognised as a strong determinant of health. Yet there is increasing concern that health in adolescence may also influence educational attainments and future life chances. We examined associations between health in early adolescence and subsequent academic and employment outcomes, exploring potential mediators of these relationships to inform intervention strategies.

Methods We used data from the Longitudinal Study of Young People in England. Adolescent health was measured at waves 1 and 2. Outcomes included educational attainment at age 16 years and being NEET (not in education, employment or training) at age 19 years. Associations were adjusted for ethnicity, area-level deprivation and early adolescent academic attainment. Where significant associations were identified, we examined the role of hypothesised mediators including attendance and truancy, classroom behaviour, substance use and psychological distress.

Results Health conditions in early adolescence predicted poor subsequent education and employment outcomes (ORs ranged from 1.25 to 1.72) with the exception of long-term chronic conditions and NEET status, which were unassociated. The most consistent mediating variable was social exclusion. School behaviour, truancy and substance use were significant mediators for mental health. Long-term absences mediated associations between mental health and physical health and later outcomes.

Conclusions Health is a key component of academic and vocational achievement. Investment in health is a way of improving life chances. The identification of key mediators such as social exclusion and truancy indicate areas where screening for health conditions and provision of targeted support could improve educational, employment and health outcomes.

  • adolescents cg
  • unemployment
  • education
  • mental health

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  • Contributors DRH led the analyses and writing of the paper. RMV conceived the work, supervised analyses and contributed to interpretation and writing.

  • Funding The Policy Research Unit at the Health of Children, Young People and Families (CPRU) is funded by the Department of Health Policy Research Programme. This is an independent report commissioned and funded by the Department of Health.

  • Disclaimer The views expressed are not necessarily those of the Department.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.