The significance levels of the coefficients in these models were more accurate than those produced by standard logistic regression, and, therefore, gave better estimates of the association between health problems and academic failure. Our second objective involved identifying the mechanisms that link physical and mental health to academic performance.
To do this, we added absenteeism, trouble with homework, and student-teacher bonding to the baseline models described above, both individually and together. The third and final objective of this study involved testing whether the association between health and academic performance varies by school context. Drawing on the social epidemiological framework, our first aim was to examine the potential risk factors that increase the likelihood of academic failure, in this case physical and mental health problems. As presented in Table 3 , self-rated health and emotional distress were both associated with a greater likelihood of failing a class in the next year, even controlling for other important sociodemographic characteristics.
Adolescents who scored one standard deviation above the mean for emotional distress at Wave I were nearly 44 percent more likely to fail one or more courses at Wave II, compared with adolescents who scored one standard deviation below the mean on emotional distress at Wave I. Recall that these models contained, as a control variable, the Wave I measure of the academic outcome, meaning that the dependent variable effectively measured a change in academic performance over a one-year period. That these associations persisted despite this conservative framework bolstered our confidence that physical and mental health problems, in terms of self-rated general health status and emotional distress, were indeed risk factors for academic failure in secondary school.
Turning to other, non-focal factors in these models, we also found that females were significantly less likely than males to experience course failure. In addition, older adolescents and those with higher self-esteem were less likely to fail. The odds of failing one or more courses at Wave II were approximately 40 percent higher for blacks compared to whites. For adolescents in stepfamilies and single-parent families, the odds of failing one or more courses were roughly 30 percent higher than for adolescents living with both biological parents.
Exploring Unequal Achievement Schools Construction – csemi
Lower parental education and lower family income were also associated with an increased probability of poor academic performance. Finally, adolescents who failed at least one course at Wave I were nearly five times more likely to fail again at Wave II, compared to those who performed satisfactorily one year earlier.
Health insurance and parental closeness were not significantly associated with course failure, once other factors were taken into account. Now that we have established physical and mental health problems as potential risk factors for academic failure, we need to explain why this risk occurs. We attempted to do so by focusing on three potential mechanisms underlying the observed associations of physical and mental health problems with academic failure. When entered into the baseline models separately, absenteeism, trouble with homework, and individual-level teacher attachment each significantly predicted course failure, but only absenteeism, on its own, accounted for a significant proportion of the association between self-rated health and academic failure.
None of these factors fully accounted for the observed association between emotional distress and course failure. Model 4 in Panels A and B of Table 4 presents results of analyses in which the three potential mechanisms were included in the baseline models simultaneously. Taken together, absenteeism, trouble with homework, and individual-level teacher attachment reduced the coefficient for self-rated health by more than 13 percent, while they accounted for approximately 66 percent of the association between emotional distress and course failure obtained by calculating the percent change in each of the health coefficients once the mediator variables were entered into the model.
Although the odds ratio for emotional distress remained significant, these analyses suggest that this set of mechanisms, encompassing multiple dimensions of academic functioning, partially explained the academic risk status of mental health problems. Students who felt bad or struggled with mental health problems were more likely to miss school, to have trouble concentrating on schoolwork, and to feel disconnected from adults in school results not shown here ; this configuration of factors disrupted their school performance.
Standard errors are in parentheses. Another important aspect of the epidemiological framework is protection—factors that moderate some risk status. Typically, studies of protection in social and psychological research have focused on interpersonal or individual factors, but this study considers a major social institution. In other words, we ask whether the risk status of physical and mental health problems is monolithic across institutional contexts or whether it varies as a function of institutional context.
As explained above, we focused on the school environment as the institutional context that may moderate the association between health problems and academic failure. In particular, we considered three school characteristics, in-school health services, school-level student-teacher bonding, and school size.
Table 5 presents the results of analyses in which these three school characteristics, and their interactions with the physical and mental health variables, were included in the baseline models predicting academic failure. Overall, these analyses revealed no evidence to suggest that the association between self-rated health and course failure was conditioned by school structure or climate. Furthermore, our analyses offered very limited support for the contention that the association between mental health and academic failure was conditioned by school context.
We found that adolescents with higher levels of emotional distress experienced a greater risk of failing at least one course at Wave II if they attended schools with higher, rather than lower, mean student-teacher bonding. For adolescents with low levels of emotional distress, the odds of course failure are approximately the same, regardless of the mean level of student-teacher bonding in their school.
For adolescents, academic failure has many negative consequences, ranging from strained parent-adolescent relations in the short-term Repetti to truncated educational attainment in the long-term Barrington and Hendricks ; Roderick Through these effects on collective individuals, academic failure also negatively affects society. Given what we know about long-term individual- and social-level consequences of academic failure in secondary school, an important goal of research is to understand the constellation of forces, both positive and negative, that underlie this social problem in order to identify ways in which social institutions can work together to better serve the needs of children, adolescents, and families.
In the present study, we have applied a social epidemiological framework to the study of academic failure in secondary school, one guided by a need to locate identifiable, manipulable risk factors and protective factors for this individual and social problem. In taking this approach, we have established physical and mental health problems as risk factors for academic failure and have addressed why and under what circumstances these health problems pose a risk to academic achievement.
Exploring Unequal Achievement in the Schools : The Social Construction of Failure
Establishing both physical and mental health problems as risk factors for academic failure is important for several reasons. First, it helps to move educational research into new areas, beyond academics. While previous research has begun to examine non-academic factors that contribute to academic problems, this is the first nationally-representative, longitudinal study to examine the role of physical and mental health problems in explaining academic failure in secondary school. Second, this basic finding suggests the need to study in tandem educational and health trajectories or, pathways over time.
Research on adult health and well-being finds that higher education predicts better health Mirowsky and Ross a. If child and adolescent health problems destabilize student trajectories through the formal schooling system, then the negative long-term association between educational attainment and adult health may be due, in part, to these early health problems.
These negative consequences spill over and negatively affect their academic performance. This finding illustrates the complexity of human development in general and the complexity of schooling adolescents in particular. In order to reduce the risk associated with health problems, schools must attend to the whole student. This includes developing intervention strategies targeted at the problems that put physically and mentally ill adolescents at risk.
Risk factors are not inalterable, but instead likely vary across social contexts. These contexts offer different levels of protection and may even exacerbate the risks already present. This study focused on school context, aiming our analyses toward potentially protective schooling environments.
Another important extension of the epidemiologic framework attempted by this study concerns the possibility that risk status varies with social context. We found only slight evidence to suggest that the association between health problems and course failure varies by schools, a finding that was counterintuitive. Rather than serving as a protective factor, high levels of student-teacher bonding within a school heightened the risk of course failure among adolescents with mental health problems. One possible explanation for this finding is that emotionally distressed students may feel especially isolated from teachers in environments with high student-teacher bonding.
We tested this hypothesis, however, using the individual-level measure of teacher attachment and found no support for it. This finding reveals the challenge to designing school interventions, in that selection effects mask apparent protective mechanisms, and programs designed to help may have unintended consequences. Cross-school, or cross-context, variability in the association between health problems and academic failure is potentially much greater than suggested by our findings. This has been the first study to consider this possibility, and much more can be done.
We have examined only between-school factors and not within-school factors. Perhaps the real variation in the association between health and academic performance occurs across different subsets of the school environment—such as curricula, student activities, and peer networks.
Although beyond the scope of this study, these possibilities can be addressed with the upcoming educational supplement to Add Health, which includes information from official school transcripts on course registration patterns, course content, and school environment. At the same time, the examination of contextual variability in this and other risk-related processes can move beyond the school level, which is only one context in the larger ecology of human development. For example, family and neighborhood contexts have been found to contribute to physical and mental health in addition to academic achievement in adolescence, which could moderate the connection between health problems and academic performance see Catsambis and Beveridge for an example of this approach.
Of course, social structural subpopulations, such as racial and ethnic groups, also serve as social contexts, albeit of the more distal variety. Preliminary analyses have revealed little variation in these processes by gender. These different levels of social context are not isolated from each other. Consequently, future research should take into account how social contexts, both proximate and distal, interact to shape education and health, and the relation between the two.
Another important avenue of future research, already mentioned, concerns the need to study educational and health trajectories within and across different stages of the life course and, moreover, the degree to which such trajectories intertwine over time. For example, linking together early health status, adolescent academic failure, and later health problems is a necessary first step in linking youth and adult literatures; comparing the academic risk status across three stages of schooling elementary, secondary, college would also be valuable.
At the same time, examining the extent to which trajectories of health problems and academic problems are interrelated across the transition to young adulthood would demonstrate the interaction among dynamic developmental trajectories in multiple domains. Surprisingly little research has considered the possibility that education and health, two key developmental domains of the early life course, are related to each other during adolescence.
As one of the first studies to explore this possibility in a national-level quantitative framework, this preliminary study provides answers to some old questions but, simultaneously, presents new questions. Our use of the social epidemiological framework to better understand one key adolescent problem suggests that the general study of social problems can benefit from considering how multiple domains of adjustment and functioning come together within a complex tapestry of social contexts, at both the micro- and macro-levels.
This study also demonstrates how adolescent research fits into the broader area of social problems. Adolescent phenomena are important because they potentially reveal the origins of social inequalities in later stages of the life course or in society as a whole. Finally, the significance of this study is practical as well as conceptual. Identifying academic risks and the contexts in which these risks are exacerbated or assuaged helps tailor interventions for particular student groups and promote the overall functioning of the educational system.
Opinions reflect those of the authors and not necessarily those of the granting agencies. The authors wish to thank Jennifer Matjasko for providing access to the Add Health data. In the case of a continuous predictor variable e. When examining a dichotomous outcome variable, such as course failure, multi-level modeling techniques must be adjusted.
We chose to present the results from the survey logit models, rather than the multi-level models, because the data cannot be weighted in Glimmix. This is a serious problem for Add Health, given the inclusion of numerous over-samples see Chantala and Tabor for more on the use of weights in Add Health. The multi-level models produced results nearly identical to those presented here, with one exception: Since this discrepancy may have been due to our inability to weight in Glimmix, we chose to focus only on those results that were found to be robust across estimation techniques.
National Center for Biotechnology Information , U. Author manuscript; available in PMC Mar Needham , Robert Crosnoe , and Chandra Muller. University of Texas at Austin. See other articles in PMC that cite the published article. Abstract This study explores whether the interplay of health problems and school environment predicts academic failure, an individual event with consequences for the life course, as well as for society at large.
The Epidemiological Framework and the Study of Academic Failure To study the prevalence of disease in specific populations, epidemiologists have developed a framework centered on the interplay of biological or environmental risk factors—that increase the probability of disease—and biological or environmental protective factors—that reduce the association between risk factors and disease. Adolescent Health and Academic Failure The first goal of this study is to determine whether physical and mental health problems are risk factors for academic failure.
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Mechanisms Underlying the Academic Risk of Health Problems General research on adults and more specialized research on children strongly suggest that poor health is a risk factor for academic performance in secondary school. Adolescent Health, Academic Failure, and School Context The adoption of the social epidemiological framework has helped to reconceptualize many studies of human development and education. Methods Sample This study draws on data from the National Longitudinal Study of Adolescent Health Add Health , a large, school-based study of adolescents, their schools, and their families.
Open in a separate window. Physical and Mental Health Two measures tap adolescent health status. Mechanisms We created three measures to explain the association of physical and mental health with academic performance. School Factors We created three measures to test whether the associations of physical and mental health with academic performance varied across schools.
Individual-level Controls In all analyses, we controlled for Wave I academic performance, which allowed the assessment of change in performance across waves.
Family-level Controls In addition to individual-level controls, we controlled for four family characteristics which previous research has established as important predictors of health and academic achievement: Plan of Analysis The first objective of this study involved the examination of the associations of physical and mental health with academic performance.
Results Adolescent Health and Academic Failure Drawing on the social epidemiological framework, our first aim was to examine the potential risk factors that increase the likelihood of academic failure, in this case physical and mental health problems. Mechanisms Underlying the Academic Risk of Health Problems Now that we have established physical and mental health problems as potential risk factors for academic failure, we need to explain why this risk occurs. Adolescent Health, Academic Failure, and School Context Another important aspect of the epidemiological framework is protection—factors that moderate some risk status.
Discussion For adolescents, academic failure has many negative consequences, ranging from strained parent-adolescent relations in the short-term Repetti to truncated educational attainment in the long-term Barrington and Hendricks ; Roderick Adolescent Health and Academic Failure Establishing both physical and mental health problems as risk factors for academic failure is important for several reasons. Adolescent Health, Academic Failure, and School Context Risk factors are not inalterable, but instead likely vary across social contexts.
Directions for Future Research Cross-school, or cross-context, variability in the association between health problems and academic failure is potentially much greater than suggested by our findings. Concluding Remarks Surprisingly little research has considered the possibility that education and health, two key developmental domains of the early life course, are related to each other during adolescence.
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