Mental or physical health problems during the teen years may make it harder to get a good job or to complete higher education later on, a new research review suggests.
"Chronic health conditions and particularly mental health conditions contribute substantially to education and employment outcomes," said study co-author Leonardo Bevilacqua, a researcher at the University College London Institute of Child Health in England.
"This is extremely important for developing and implementing policies in and outside schools that promote health and support those with health conditions," he said.
Teens' health needs to be a core focus in school to improve their educational and employment success, Bevilacqua added.
Although the review found an association between mental or physical health problems in teens and greater difficulty pursuing a higher education or getting work, the study did not prove a definitive cause-and-effect relationship between those factors.
The findings were published online June 22 in the journal Pediatrics.
27 different studies reviewed
The researchers reviewed 27 studies that looked at teens with and without chronic mental or physical health conditions, and compared their education and employment situations as adults.
Most of the studies accounted for differences in sex, ethnicity or the family's socioeconomic status, but not all did.
As a whole, the researchers found that teens with mental or physical health conditions did more poorly as adults in terms of education and employment.
Researchers looked at problems that included dropping out of high school, not getting additional education after high school, and having fewer years of education. They also examined time spent unemployed, income, welfare use and whether a person held an unskilled job.
The link to poorer outcomes was strongest for those with mental health conditions. But only nine studies included teens with physical health problems. Six looked at unspecified chronic health problems, and three of these focused on juvenile idiopathic arthritis.
A possible reason for the findings is that teens with health problems miss more school and don't participate in social or school activities as much, Bevilacqua said.
"This research suggests that people with health conditions may be more likely to be socially excluded, potentially due to stigmatisation or a lack of social contact with peers, which has a negative impact on their educational development," he said.
"Poor mental health may contribute to conduct problems in school, truancy and substance use, which are also disruptive to outcomes," he added.
One expert who looked at the review was surprised that some illnesses weren't in the findings.
"I would have expected to see other ailments that heavily influenced outcomes to include diabetes, asthma and cancer, but these were not specifically mentioned," said Dr. Danelle Fisher, vice chair of paediatrics at Providence Saint John's Health Center in Santa Monica, Calif.
Most suffer from mental health concerns
The most common condition studied was depression, followed by conduct disorder, attention deficit hyperactivity disorder, anorexia, anxiety disorders and other psychiatric disorders, the researchers said.
Another expert surmised that many teens are already in a somewhat vulnerable state.
"Adolescence is filled with enough distractions from educational attainment already," said Dr. Omar Khan, associate vice chair of Christiana Care Health System's department of Family and Community Medicine in Wilmington, Del.
"For someone with a mental health issue, the inability to concentrate, such as with ADHD, or the distraction of the intellect to instead focus on antisocial behaviours, such as with conduct disorder, are likely profound enough that they decrease school performance," he said.
The key to success for teens with health challenges is to have good access to consistent, effective primary care and behavioural health, he said.
"Teen-related mental health issues can be diagnosed and managed so that good mental health is a lifelong pursuit, just like exercise and a balanced diet," Khan said. In addition, "focusing on the affected child's assets or strengths is an important way to accentuate ways to increase attainment," he said.
All the experts noted that programs are often available to help parents meet their children's needs. Fisher mentioned that support groups may be available through local universities or community care centers. Bevilacqua suggested that parents can talk to their child's doctor or a psychologist to find out what resources exist in their area, or ask schools to offer programs.
"Schools can help struggling young people with good school-based health services, including support for students with health conditions, and good communication with parents," Bevilacqua said.