Abstract
BACKGROUND: Health is a multifaceted concept with existing evidence in the UK indicating a negative association between educational outcomes and markers of ill-health. Evidence that disaggregates the influence of physical and mental health conditions on educational attainment, using population wide linked administrative data, varies between UK jurisdictions, with a lack of such research evident in Northern Ireland (NI). This study aims to address this gap by investigating the impact of students' physical and mental health on post-primary attainment in NI. This is a pertinent area as the recent Children and Young People's Emotional Health and Wellbeing in Education Framework outlined the need for cross-departmental collaboration between education and health. METHODS: Using administrative data that linked the household Census (2011), School Leavers Survey (2010-2014) and School Census (2010-2014), this study examines the associations between young people's GCSE attainment, physical health and mental health (n = 61,373). Multilevel models were executed to account for the nested data structure and wider demographic profile of young people. Interaction terms were also tested between factors such as sex, socio-economic background, and physical and mental ill-health markers to determine their effects on attainment. RESULTS: The study confirmed the negative associations between lower post-primary attainment and 'very bad' self-reported health status (d = -1.01, 95% CI: -1.26, -0.75), the presence of a physical health condition (d = -0.39, 95% CI: -0.41, -0.36), mental health condition (d = -0.91, 95% CI: -1.00, -0.82) and an illness/disability that limited daily activity a little (d = -0.48, 95% CI: -0.53, -0.44) or a lot (d = -0.98, 95% CI: -1.04, -0.92). Interaction terms were tested, and significant associations were evident between sex and physical health condition, sex and mental health condition, free school meal eligibility and physical health condition, and the presence of both a physical health condition and mental health condition. CONCLUSION: This study is the first instance where population wide, linked administrative data is used to examine the associations between educational attainment and students' physical and mental health in NI. The importance of mental health and the greater educational disadvantage some social groups may experience are key implications for policy.