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- Bortes, Cristian, 1984-
(author)
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Growing up with poor health and managing school : Studies on ill health and young people's educational achievements
- 2022
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Doctoral thesis (other academic/artistic)abstract
- Aim and objectives: The overall aim of this thesis was to empirically investigate consequences of poor health for children’s educational outcomes in Sweden. A central tenet is that health problems impact not only the afflicted individual but also people in their social and emotional proximity, in particular immediate family members. More specific objectives were to study: 1. The relationship between multiple clinically diagnosed mental disorders and children’s educational achievements in Sweden. 2. The bidirectional relationship between mental health problems and academic performance among Swedish adolescents, as well as heterogeneous patterns associated with gender and socioeconomic groups. 3. The effects of parental somatic and psychiatric health problems on the probability of youths leaving upper secondary education before completion in Sweden and potential gender differences in these effects. 4. The relationship between having a sibling with health problems and a healthy sibling’s school grades in the final year of compulsory education in Sweden and how socioeconomic background modifies this relationship.Theoretical framework: Key concepts applied in the thesis are health and illness. The ability to perform things in life, the ability to act, determines whether a person is healthy or ill. Illness (or poor health, treated as a synonymous term) entails a reduced ability to act in relation to one’s life situation and its demands. Family is viewed from a systems theory perspective. Poor health of a parent reduces his or her ability to maintain regular roles, which may require reorganisation of the family system. Siblings’ health problems can affect other children in the family by inducing concerns and occupying and diverting parents’ time and attention. All of this could be psychosocially stressful in many ways, not least for children in the family and their ability in relation to schooling.Data and methods: The research objectives were addressed by utilising social and medical microdata from Swedish administrative registers covering the entire population in Sweden. Data pertaining to different populations, collectively covering the period from 1987 to 2017, were used in four studies designated Studies I–IV. Educational achievement was measured in terms of teacher-assigned school grades awarded by the end of compulsory school and in upper secondary school, as well as completion (or non-completion) of an upper secondary education. Poor health was measured through data on outpatient visits to specialist healthcare facilities, psychotropic drug prescriptions and admissions/discharges from Swedish hospitals. Socioeconomic background was measured by parental level of education. The data were analysed by fitting linear and logistic regression models as well as cross-lagged path models.Results and conclusions: Empirical results of Study I showed that specific diagnosed mental disorders have varying, largely disadvantageous, associations with educational achievements of students that differ between boys and girls. Documentation of this in Sweden adds to evidence that mental disorders have a negative overall association with educational achievement, despite substantial variation in support and educational systems across countries. The results of Study II provided no support for a bidirectional relationship between mental health and academic performance of students aged 15-16 to 18-19 years. However, they support a unidirectional relationship, as a negative relationship was found between school grades at graduation from compulsory school and rates of subsequent psychotropic medication use in upper secondary school. The relationship was equal in size for both boys and girls but mainly among adolescents with the highest educated parents.Study III showed that having a mother or a father with psychiatric, but not somatic, illness that necessitated hospitalisation after completing compulsory schooling was associated with an increased probability of leaving upper secondary school before completion. No significant gender-based differences in this were found. Results presented in Study IV showed that having one or more siblings with health problems that necessitated recurrent hospitalisations was associated with lower grades. Children with ill siblings were also less likely to be eligible for an upper secondary education compared to children whose siblings did not have poor health. Socioeconomic background did not affect this educational disadvantage.Results presented in this thesis clearly corroborate the importance of health for children’s education. Children’s educational achievements at the end of compulsory school are inversely related to mental health problems in their adolescence. Thus, academic competence may have positive effects on certain aspects of young people’s mental health, which underscores the importance of promoting opportunities for youth to do as well as they can in school. The reciprocal aspect of the relationship between mental health and academic performance among school-aged children remains an important issue that requires further investigation. However, health is not just an individual issue; parents’ and siblings’ health problems can affect children and have negative ‘spillover’ effects on their schooling and educational achievements. This underlines the importance of a psychosocial perspective when identifying children’s difficulties in school. Taken together, health, and thus the school’s student health task, is highly associated with academic achievement and schools’ pedagogical responsibilities.
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- Assarsson, Rebecka, et al.
(author)
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Gender inequality and adolescent suicide ideation across Africa, Asia, the South Pacific and Latin America : a cross-sectional study based on the Global School Health Survey (GSHS)
- 2019
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In: Global Health Action. - : Taylor & Francis. - 1654-9716 .- 1654-9880. ; 11
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Journal article (peer-reviewed)abstract
- Background: Suicide ideation is a health issue affecting adolescents worldwide. There are significant variations in suicide ideation between countries and genders, which have not been fully explained. Research is especially lacking in countries outside Europe and North America. Gender equality has been shown to matter in other aspects of adolescent mental health, such as life satisfaction, but has not been researched in relation to suicide ideation at national level.Objective: To investigate how national gender inequality is related to self-reported suicide ideation among adolescents, and whether this association differs between boys and girls.Methods: This is a cross-national, cross-sectional study using individual survey data from the Global School-based Student Health Survey, a survey in Africa, Asia, Latin America and the South Pacific, developed and supported by among others the WHO and the CDC; connecting this to national data: the gender inequality index from the UNDP; controlling for GDP per capita and secondary school enrolment. The data was analysed using a multilevel logistic regression method and included 149,306 students from 37 countries.Results: Higher national gender inequality, as measured by the gender inequality index, was significantly associated with a higher likelihood of suicide ideation in both girls and boys (odds ratio: 1.38 p-value: 0.015), but for girls and both sexes this was only after adjusting for selection bias due to secondary school enrolment (as well as GDP/capita). Interaction models showed that this association was stronger in boys than in girls.Conclusions: National gender inequality seems to be associated with higher levels of suicide ideation among adolescents in mainly low- and middle-income countries, especially among boys.
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- Baranowska-Rataj, Anna, 1980-, et al.
(author)
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When things go wrong with you, it hurts me too : The effects of partner’s employment status on health in comparative perspective
- 2021
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In: Journal of European Social Policy. - : Sage Publications. - 0958-9287 .- 1461-7269. ; 31:2, s. 143-160
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Journal article (peer-reviewed)abstract
- The effects of changes in employment status on health within couples have attracted increasing attention. This paper contributes to this emerging research by investigating whether the impact of a partner’s employment status on individual self-rated health varies systematically across countries with varying decommodification levels. We use longitudinal data from the European Union Statistics on Income and Living Conditions (EU-SILC) and hybrid models. We find that a change in an individual’s employment status may affect the health not just of the person who experiences this transition, but that of his or her partner. The likelihood that such a spillover will occur varies across countries with different decommodification levels. The negative effects of a partner’s employment status on self-rated health are observed when the generosity of welfare state support is limited. The moderating effects of financial support from the state are not very strong, though. They are not robust across all our models and do not extend to all the dimensions of the generosity of welfare state support.
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- Baranowska-Rataj, Anna, 1980-, et al.
(author)
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When things go wrong with you, it hurts me too : The effects of partner’s employment status on health in comparative perspective
- 2020
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Reports (other academic/artistic)abstract
- The effects of changes in employment status on health within couples have attracted increasing attention. This paper contributes to this emerging research by investigating whether the impact of a partner’s employment status on individual self-rated health varies systematically across countries with varying decommodification levels.We use longitudinal data from the European Union Statistics on Income and Living Conditions (EU-SILC) and hybrid models. We find that a change in an individual’s employment status may affect the health not just of the person who experiences this transition, but of his or her partner. The likelihood that such a spillover will occur varies across countries with different decommodification levels. The negative effects of a partner’s employment status on self-rated health are observed when the generosity of welfare state support is limited. The moderating effects of financial support from the state are not very strong, though, they are not robust across all our models and do not extend to all the dimensions of the generosity of welfare state support.
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- Bortes, Cristian, et al.
(author)
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Associations between children’s diagnosed mental disorders and educational achievements in Sweden
- 2022
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In: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 50:8, s. 1140-1147
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Journal article (other academic/artistic)abstract
- Aims: To examine associations between multiple clinically diagnosed mental disorders among children in Sweden and educational achievements at the end of ninth grade.Methods: Data from Swedish administrative registers were utilised. Diagnoses of specific mental disorders (unipolar depression, mood, anxiety, obsessive compulsive, eating, attention deficit hyperactivity disorder) were used as exposure variables. Educational achievements were assessed in terms of teacher-assigned school grades and eligibility for upper secondary education. The sample comprised 266,664 individuals (49% females) born in 2000 to 2002 who were alive and resident in Sweden in 2017. Exposed and unexposed individuals were compared in terms of outcome variables by fitting linear and logistic regression models.Results: The results revealed negative associations between all the examined mental disorders and educational achievements, except for positive associations between eating disorders and grades among female students. Attention deficit hyperactivity disorder was the most strongly associated disorder in terms of non-successful completion of compulsory education, among both male and female students (odds ratio (OR): 3.58 (95% confidence interval (CI), 3.42 to 3.74) and 4.31 (95% CI, 4.07 to 4.57), respectively). This was followed by unipolar depression among males (OR: 2.92 (95% CI, 2.60 to 3.28)) and anxiety disorder among females (OR: 2.68 (95% CI, 2.49 to 2.88)). Obsessive compulsive disorder had the weakest negative association with educational achievements among both males (OR: 1.48 (95% CI, 1.01 to 2.17)) and females (OR: 1.38 (95% CI, 1.11 to 1.72)).Conclusions: Specific diagnosed mental disorders have varying, largely disadvantageous, associations with educational achievements of students in Sweden that differ between males and females.
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- Bortes, Cristian, et al.
(author)
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Psychotropic medication use and academic performance in adolescence : A cross-lagged path analysis
- 2021
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In: Journal of Adolescence. - : Elsevier. - 0140-1971 .- 1095-9254. ; 91, s. 25-34
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Journal article (peer-reviewed)abstract
- Introduction: The study investigated the directionality of associations between mental health problems and school grades across two timepoints (T1 and T2) during mid to late adolescence; in school year 9 (ages 15-16) and school year 12 (ages 17-18). The study also investigated variation in the associations as a function of gender and across socioeconomic groups. Methods: Longitudinal data from several Swedish administrative registers were utilised. Information on prescribed psychotropic drugs was used as a proxy for mental health problems, and teacher-assigned school grades were used to measure academic performance. The study sample comprised 85 186 individuals (50.7% girls) born in 1991 who were alive and resident in Sweden in 2010. Directions of associations were analysed by estimating a series of cross-lagged path models. Results: The model with the best fit to data showed that higher school grades at T1 were associated with relatively lower rates of mental health problems by T2, for both boys and girls, mainly in socioeconomic groups with the highest educated parents. This association was equal in size across all of the socioeconomic groups that were explored. Conclusions: Performing well in school is equally important for boys' and girls' subsequent mental health, but only among adolescents in socioeconomic groups with the highest educated parents. The results underscore the importance of promoting opportunities for youth to do as well as they can in school.
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- Bortes, Cristian, et al.
(author)
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The Bidirectional Relationship Between Subjective Well-Being and Academic Achievement in Adolescence
- 2021
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In: Journal of Youth and Adolescence. - : Springer. - 0047-2891 .- 1573-6601. ; 50:5, s. 992-1002
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Journal article (peer-reviewed)abstract
- The well-being of young people in relation to their school performance has received increased attention in recent years. However, there is a lack of knowledge about the longitudinal and reciprocal relationship between adolescents' subjective well-being and their academic achievements. The current study examined the bidirectional relationship between subjective well-being and academic achievement across two timepoints (T1 and T2) during the course of mid to late adolescence, i.e., in school year 9 (age 15), and school years 11-12 (ages 17-18). The study also investigated variation in the association as a function of adolescent gender. Data on subjective well-being and teacher-assigned school grades of 723 adolescents (48.7% girls) residing in Sweden were analyzed by estimating a series of cross-lagged path models. The findings suggest gender differences in the relationship as no associations were found among boys. Support for a bidirectional relationship between the constructs was only found for girls. For girls, higher subjective well-being at T1 was associated with higher academic achievements at T2, while higher academic achievements at T1 was associated with lower subjective well-being at T2. These findings highlight that the subjective well-being of adolescent girls may be important for their ability to perform at school, but their academic achievements may also inflict negatively on their subjective well-being.
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