Adolescent Chronic Health Conditions and School Disconnectedness

Abstract

Objective: The objective of this study was to examine associations between chronic health conditions and school disconnectedness, trouble getting along with others at school, and peer victimization at age 15. Method: We conducted a secondary analysis of population-based data from the Fragile Families and Child Wellbeing birth cohort to investigate associations between chronic developmental/behavioral and physical health conditions and school disconnectedness, trouble getting along with others at school, and peer victimization of adolescents using mother-reported child health conditions and youth-reported relationships/experiences at school ascertained from standardized scales. Associations were examined using linear and logistic regression models adjusting for confounding factors. Results: Of the 2874 adolescents included, more than one-third had at least 1 chronic health condition. Compared with those with no chronic health conditions, adolescents with developmental/behavioral health conditions felt more disconnected from school (by 0.22 SDs), had more trouble getting along with others at school (0.22 SD), and were more victimized by peers at school (0.20 SD). Teens with physical health conditions also felt more disconnected from school (0.10 SD), had more trouble getting along with others at school (0.12 SD), and were more victimized by peers (0.12 SD). One noteworthy difference was that adolescents with developmental/behavioral conditions were more likely than those with no conditions to report trouble getting along with teachers, but adolescents with physical health conditions were not. Conclusion: Chronic health conditions were associated with disconnectedness from school and negative school social interactions in this study of US urban youth, suggesting that targeted resources and interventions for this population are needed.

Chronic health conditions and adolescents’ social connectedness.

“…Interventions that increase school and family connectedness are also important for youth with disabilities given the findings of this study and previous research on chronic health conditions or disability of youth and school disconnectedness (James et al, 2022) and family stress (Cousino & Hazen, 2013;F. Craig et al, 2016).…”

“…Craig et al, 2016). This could include reducing peer victimization and increasing time with teachers for support and connection (James et al, 2022) as well as greater resources and support for parents to manage problematic behaviors and cope with stressors (F. Craig et al, 2016). Family teamwork for spreading out caregiving duties and adding support, such as aides, to assist with caregiving needs when possible could also reduce parental stress (Cousino & Hazen, 2013).…”

“…Craig et al, 2016). This could include reducing peer victimization and increasing time with teachers for support and connection (James et al, 2022) as well as greater resources and support for parents to manage problematic behaviors and cope with stressors (F. Craig et al, 2016).…”

“…Studies have found lower levels of social competence, social functioning, and social connectedness in youth with chronic illnesses, such as cancer, obesity, and autism, but systematic reviews and meta-analyses concluded that the quality of most studies on the topic was mediocre at best (Diendorfer et al, 2021; Martinez et al, 2011; Pinquart & Teubert, 2012). More recent studies based on a national urban birth cohort found that youth with chronic and potentially disabling health conditions felt less connected to school, had more trouble getting along with teachers and peers, and had lower rates of participation in school and community activities compared to youth with no chronic conditions (James et al, 2022; Noonan et al, 2020). Another study of more than 1,600 high school students with a wide range of learning, emotional, and physical disabilities also found lower levels of school connectedness among these youth with disabilities (Forber-Pratt et al, 2021).…”

Culturally Responsive Opioid and Other Drug Prevention for American Indian/Alaska Native People: a Comparison of Reservation- and Urban-Based Approaches

“…Within the urban environment, socially engaging with other AI/AN people and organizations is inherently challenging. This is important to recognize as social disconnectedness has been shown to adversely affect health among ethnic minority groups in urban areas (James et al, 2021 ). Furthermore, not being able to connect with other AI/AN people and organizations may decrease the potential for enhancing a healthy sense of cultural identity, pride, and learning about and participating in traditional practices.…”