Abstract
BackgroundAsthma has the potential to adversely affect children's school examination performance, and hence longer term life chances. Asthma morbidity is especially high amongst UK ethnic minority children and those experiencing social adversity, populations which also have poor educational outcomes. We tested the hypothesis that asthma adversely affects performance in national school examinations in a large cohort from an area of ethnic diversity and social deprivation.Methods and FindingsWith a novel method (using patient and address-matching algorithms) we linked administrative and clinical data for 2002–2005 for children in east London aged 5–14 years to contemporaneous education and social care datasets. We modelled children's performance in school examinations in relation to socio-demographic and clinical variables.The dataset captured examination performance for 12,136 children who sat at least one national examination at Key Stages 1–3. For illustration, estimates are presented as percentage changes in Key Stage 2 results. Having asthma was associated with a 1.1% increase in examination scores (95%CI 0.4 to 1.7)%,p = 0.02. Worse scores were associated with Bangladeshi ethnicity −1.3%(−2.5 to −0.1)%,p = 0.03; special educational need −14.6%(−15.7 to −13.5)%,p = 0.02; mental health problems −2.5%(−4.1 to −0.9)%,p = 0.003, and social adversity: living in a smoking household −1.2(−1.7 to −0.6)%,p<0.001; living in social housing −0.8%(−1.3 to −0.2)% p = 0.01, and entitlement to free school meals −0.8%(−1.5 to −0.1)%,p<0.001.ConclusionsSocial adversity and ethnicity, but not asthma, are associated with poorer performance in national school examinations. Policies to improve educational attainment in socially deprived areas should focus on these factors.
Highlights
Asthma is the commonest long-term disorder affecting children in the UK and most economically-developed countries. [1] Health status and education of children are closely linked. [2] In a recent review on asthma in children [3], no mention was made of asthma’s impact on educational performance, an important omission given the increasing recognition for a move to assessing impact of long-term conditions on patient/parental-centred outcomes
Policies to improve educational attainment in socially deprived areas should focus on these factors
Populations at particular risk are children of low socioeconomic status and children of south Asian and Black ethnic minority origin: both experience increased asthma morbidity and poor educational attainment. [14,15] no study has examined the impact of asthma on school examination performance in children from large ethnically diverse socio-economically deprived populations
Summary
Asthma is the commonest long-term disorder affecting children in the UK and most economically-developed countries. [1] Health status and education of children are closely linked. [2] In a recent review on asthma in children [3], no mention was made of asthma’s impact on educational performance, an important omission given the increasing recognition for a move to assessing impact of long-term conditions on patient/parental-centred outcomes. [14,15] no study has examined the impact of asthma on school examination performance in children from large ethnically diverse socio-economically deprived populations. Populations at particular risk are children of low socioeconomic status and children of south Asian and Black ethnic minority origin: both experience increased asthma morbidity and poor educational attainment. Results of such a study would help guide policy by identifying and targeting potentially modifiable factors that relate to poor educational attainment. We tested the hypothesis that asthma adversely affects performance in national school examinations in a large cohort from an area of ethnic diversity and social deprivation
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