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Impact of an injury hospital admission on childhood academic performance: a Welsh population-based data linkage study
Joanna F Dipnall1,2, Jane Lyons3,4, Ronan A Lyons5,3,4,6
1School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia joanna.dipnall@monash.edu.
Insights
Childhood injuries negatively impact academic performance, with specific injury types like pedestrian incidents and self-harm showing significant associations. Preventing injuries and providing targeted educational support are crucial for children's academic success.
Area of Science:
- Pediatric Health
- Educational Psychology
- Public Health
Background:
- Injuries pose significant but poorly quantified risks to children's educational achievement, development, and future employment.
- This study addresses the need to understand the long-term academic consequences of injury-related hospital admissions in children.
Purpose of the Study:
- To investigate the impact of injury-related hospital admissions on the academic performance of children in Wales.
- To quantify the association between various injury types and educational outcomes.
Main Methods:
- A population-based longitudinal study linked data from the Secure Anonymised Information Linkage databank and the Wales Electronic Cohort for Children.
- Included 55,587 children residing in Wales from 2006 to 2016 with injury hospital admissions.
- Educational achievement was measured using the Core Subject Indicator across key stages 2, 3, and 4, with adjustments for demographic, birth, injury, and school characteristics.
Main Results:
- Negative associations were found between educational achievement and pedestrian injuries, cyclist injuries, falls, fire/smoke incidents, cutting/piercing injuries, intentional self-harm, traumatic brain injuries, contusions, vertebral fractures, femur fractures, and internal abdominal/pelvic hemorrhage.
- Factors such as young maternal age, socioeconomic status, and requiring special educational needs were also negatively associated with academic performance.
- Positive associations were observed for female children, larger school sizes, and mothers aged 30+ years.
Conclusions:
- Preventing childhood injuries and implementing targeted intervention programs are essential for supporting children's education.
- Equity-focused educational support and social policies are needed for children at risk of underachievement, particularly those from disadvantaged backgrounds.
Background:
While injuries can impact on children's educational achievements (with threats to their development and employment prospects), these risks are poorly quantified. This population-based longitudinal study investigated the impact of an injury-related hospital admission on Welsh children's academic performance.
Methods:
The Secure Anonymised Information Linkage databank, 55 587 children residing in Wales from 2006 to 2016 who had an injury hospital admission (58.2% males; 16.8% born in most deprived Wales area; 80.1% one injury hospital admission) were linked to data from the Wales Electronic Cohort for Children. The primary outcome was the Core Subject Indicator reflecting educational achievement at key stages 2 (school years 3-6), 3 (school years 7-9) and 4 (school years 10-11). Covariates in models included demographic, birth, injury and school characteristics.
Results:
Educational achievement of children was negatively associated with: pedestrian injuries (adjusted risk ratio, (95% CIs)) (0.87, (0.83 to 0.92)), cyclist (0.96, (0.94 to 0.99)), high fall (0.96, (0.94 to 0.97)), fire/flames/smoke (0.85, (0.73 to 0.99)), cutting/piercing object (0.96, (0.93 to 0.99)), intentional self-harm (0.86, (0.82 to 0.91)), minor traumatic brain injury (0.92, (0.86 to 0.99)), contusion/open wound (0.93, (0.91 to 0.95)), fracture of vertebral column (0.78, (0.64 to 0.95)), fracture of femur (0.88, (0.84 to 0.93)), internal abdomen/pelvic haemorrhage (0.82, (0.69 to 0.97)), superficial injury (0.94, (0.92 to 0.97)), young maternal age (<18 years: 0.91, (0.88 to 0.94); 19-24 years: 0.94, (0.93 to 0.96)); area based socioeconomic status (0.98, (0.97 to 0.98)); moving to a more deprived area (0.95, (0.93 to 0.97)); requiring special educational needs (0.46, (0.44 to 0.47)). Positive associations were: being female (1.04, (1.03 to 1.06)); larger pupil school sizes and maternal age 30+ years.
Conclusion:
This study highlights the importance on a child's education of preventing injuries and implementing intervention programmes that support injured children. Greater attention is needed on equity-focused educational support and social policies addressing needs of children at risk of underachievement, including those from families experiencing poverty. VIBES-JUNIOR STUDY PROTOCOL: http://dx.doi.org/10.1136/bmjopen-2018-024755.
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