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

大约四分之一的年轻人由于长期缺课而错过了大量的教育（10%或更多）。虽然据推测，在大流行之后，学校出勤率将会恢复，但很大一部分年轻人仍然没有持续上学。据报告，年轻人主要是由于健康问题，包括焦虑等心理健康症状而缺课。然而，我们不知道产妇保健、社会服务接触以及个人身心健康如何导致长期缺课和受教育程度方面的不平等。与享有特权的同龄人相比，处境不利的年轻人往往在评估中表现不佳，缺课的时间更长。儿童和青少年时期健康状况不佳有可能解释家庭社会经济环境（SECs）与不良教育成果之间的某些关系。健康状况不佳可能通过负面症状、学习中断和缺课影响教育成就。此外，长期缺课可能通过与同龄人的距离、社会孤立和焦虑，增加年轻人出现心理健康问题的风险。此外，低SECs的父母更有可能精神和身体健康状况不佳。父母的心理健康不仅通过遗传特征，而且通过父母的心理问题对青少年自身的心理健康产生重大影响，这些问题可能导致消极的养育行为、对儿童需求缺乏关注、家庭和社会服务接触功能障碍增加。背景：2019冠状病毒病大流行和当前的生活成本危机加剧了年轻人面临的公共卫生挑战。生活在绝对贫困中的青年人数继续急剧增加，这一流行病的间接影响包括年轻人心理健康问题发生率的急剧上升，以及获得和接受主要预防和早期干预服务的机会减少。目的和研究问题：本研究的总体目的是评估英格兰与青少年（11-18岁）长期缺课和教育成就方面的社会不平等有关的产妇保健、家庭社会服务接触和年轻人身心慢性病的相对重要性。使用ECHILD数据库；在2019冠状病毒病大流行前后，我将研究以下问题：在屡次缺勤、成绩差或被学校排斥的年轻人中，有多大比例的人患有潜在的慢性精神或身体健康问题？家庭劣势和教育结果之间的关联有多少可归因于家庭风险因素或年轻人潜在的慢性精神或身体健康状况？自大流行以来，健康对教育不平等的影响是否发生了变化？健康和教育不平等之间的关系是否因学校、地方当局或地区而异？该奖学金还将用于扩大ECHILD数据的能力，以回答未来的研究问题，即青春期频繁缺勤或受教育程度低是否预示着成年早期的健康状况。应用和效益：我将讨论卫生与教育/社会保健需求之间相互作用方面的重要差距，包括大流行病以来所经历的复合不利情况。关于调查结果的数字共同制作材料将使家庭和年轻人、从业人员和教师能够更好地管理健康与教育之间的关系。

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.