How do mental and physical health problems contribute to inequalities in persistent school absence? A causal mediation analysis using ECHILD

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Around one in four young people are missing a large amount of education through persistent absence from school (10% or more missed). While it was presumed that school attendance levels would recover following the pandemic, a large proportion of young people still not consistently attend school. It is reported that young people are predominantly absent from school due to health concerns, including mental health symptoms such as anxiety. Yet, we do not know how maternal health, social service contacts, and individual mental and physical health contribute to inequalities in persistent school absence and educational attainment.Disadvantaged young people more often perform poorly in assessments and spend more time absent from education compared to privileged peers. Poor health during childhood and adolescence has the potential to explain some of the relationship between family socioeconomic circumstances (SECs) and poor educational outcomes. Poor health is likely to impact educational attainment through negative symptoms, disruption of learning, and school absence. Furthermore, long-term school absence is likely to contribute to young people's risk of mental health difficulties through distance from peers, social isolation, and anxiety.In addition, parents with low SECs are more likely to have poor mental and physical health. Parental mental health has a substantial impact on young people's own mental health, not only through inherited characteristics but also through parents' psychological problems that may lead to negative parenting behaviours, lack of attention to children's needs, increased dysfunction at home and social service contact.The context:Public health challenges for young people have been exacerbated by both the Covid-19 pandemic and the current cost of living crisis. The number of young people living in absolute poverty continues to rise dramatically, and the indirect impacts of the pandemic include a step-change increase in rates of mental health problems among young people, as well as reduced access to, and uptake of, key preventive and early intervention services.Aims and research questions:The overall aim of this fellowship is to assess the relative importance of maternal health, family social service contacts, and young peoples' mental and physical chronic conditions associated with social inequalities in adolescent (aged 11-18 years) persistent school absence and educational attainment in England. Using the ECHILD database; linked data on education, social care, and health before and after the covid-19 pandemic, I will examine the following questions:What proportion of young people experiencing repeated absence, poor attainment, or school exclusion have underlying chronic mental or physical health conditions?How much of the association between family disadvantage and educational outcomes is attributable to family risk factors or underlying chronic mental or physical health conditions in young people?Has the impact of health on educational inequalities changed since the pandemic?Does the relationship between health and educational inequalities vary by school, Local Authority or region?The fellowship will also be used to scope the ability of the ECHILD data to answer future research questions on whether frequent absences or poor educational attainment during adolescence predict health into early adulthood.Applications and benefits:I will address important gaps in the interplay between health and education/social care needs, including the compound disadvantage experienced since the pandemic. Digital co-produced materials on findings will inform and empower families and young people, practitioners, and teachers to better manage the relationship between health and education.