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Canadian Journal of Public Health = Revue Canadienne de Santé Publique logoLink to Canadian Journal of Public Health = Revue Canadienne de Santé Publique
. 2008 Jul 1;99(4):344–349. doi: 10.1007/BF03403769

How Health Status Affects Progress and Performance in School

A Population-based Study

Randall R Fransoo 123,✉, Noralou P Roos 123, Patricia J Martens 123, Maureen Heaman 223, Benjamin Levin 323, Dan Chateau 123
PMCID: PMC6975689  PMID: 18767284

Abstract

Objective

To assess the effects of health status at birth and health status in the preschool years on educational outcomes to age 9 in a population-based birth cohort.

Methods

Administrative data were used to follow all children born to Winnipeg mothers in 1990, and remaining in Manitoba until September 2004 (N=5,873). A structural equation model was used, incorporating latent variables to represent Health Status at Birth, Major Illness and Minor Illness during the preschool years. The model also included the child’s sex and exact age, along with a number of social, economic, and demographic characteristics of the child’s family. The outcome was a combination of marks on Grade 3 Standards Tests and enrolment in the appropriate grade for age.

Results

Major Illness in the preschool years had a significant influence on progress and performance in school (p=0.0003), predicting 1.26% of the variation in the outcome. Minor Illness was weaker but still significant (p<0.01). Health Status at Birth was not directly related to the outcome; its effect was mediated by Major and Minor Illness in childhood. Overall, the strongest predictors were the child’s age and the area-level income, followed by the mother’s age, family receipt of income assistance, the sex of the child, breastfeeding initiation (all p<0.0001), and Major Illness.

Conclusions

Health status plays a statistically significant but substantively small role in explaining progress and performance in school among a population-based cohort. Major Illness was more important than Minor Illness, and these two factors completely mediated the influence of Health Status at Birth on the outcome. The strength of the social, economic, and demographic variables underscores the importance of the broader factors that affect both health and educational outcomes.

Key words: Child health, health status, health services, social determinants, health policy

Footnotes

Sources of support: This work was supported by the Manitoba Centre for Health Policy, the RBC Foundation, the Evelyn Shapiro Health Services Research Award, and the Manitoba Health Research Council (Dissertation award).

Disclaimer: The results and conclusions are those of the authors and no official endorsement by supporting agencies was intended or should be inferred.

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