Department of Medicine, Stanford University, Stanford, CA, USA.
Ann Epidemiol. 2013 Apr;23(4):179-84. doi: 10.1016/j.annepidem.2013.01.001. Epub 2013 Feb 12.
Chronic health conditions are common and increasing among U.S. children and youth. We examined whether chronic health conditions are associated with low school performance.
This retrospective cohort study of 22,730 children and youth (grades 2-11) in San Jose, California, was conducted from 2007 through 2010. Health conditions were defined as chronic if reported in each of the first 2 years, and school performance was measured using standardized English language arts (ELA) and math assessments.
Chronic health conditions were independently associated with low ELA and math performance, irrespective of ethnicity, socioeconomic status, or grade level. Adjusted odds ratios for the association between any chronic health condition and low ("basic or below") performance were 1.25 (95% confidence interval [CI], 1.16-1.36; P < .001) for ELA and 1.28 (95% CI, 1.18-1.38; P < .001) for math, relative to students without reported health conditions. Further adjustment for absenteeism had little effect on these results. The strongest associations were found for ADHD, autism, and seizure disorders, whereas a weak association was found for asthma before but not after adjusting for absenteeism, and no associations were found for cardiovascular disorders or diabetes.
Chronic neurodevelopmental and seizure disorders, but not cardiovascular disorders or diabetes, were independently associated with low school performance among children and youth.
慢性健康状况在美国儿童和青少年中较为常见且呈上升趋势。我们研究了慢性健康状况是否与学习成绩差有关。
这是一项回顾性队列研究,共纳入了 2007 年至 2010 年期间加利福尼亚州圣何塞的 22730 名 2-11 年级的儿童和青少年。如果在最初的 2 年中报告了健康状况,则将其定义为慢性疾病,使用标准化英语语言艺术(ELA)和数学评估来衡量学习成绩。
不论种族、社会经济地位或年级水平,慢性健康状况与 ELA 和数学成绩差(“基础或以下”)均独立相关。与没有报告健康状况的学生相比,任何慢性健康状况与低成绩(“基础或以下”)相关的调整比值比(OR)分别为 1.25(95%置信区间[CI],1.16-1.36;P <.001)和 1.28(95% CI,1.18-1.38;P <.001)。进一步调整缺勤情况对这些结果影响不大。ADHD、自闭症和癫痫障碍的关联最强,而哮喘的关联在调整缺勤情况之前较强,但调整后则较弱,心血管疾病或糖尿病与学习成绩差无关。
除了心血管疾病或糖尿病外,慢性神经发育和癫痫障碍与儿童和青少年的学习成绩差独立相关。