Centre for Primary Care and Public Health, Blizard Institute, Barts and The London Medical School, London, United Kingdom.
PLoS One. 2012;7(11):e43977. doi: 10.1371/journal.pone.0043977. Epub 2012 Nov 14.
Asthma has the potential to adversely affect children's school examination performance, and hence longer term life chances. Asthma morbidity is especially high amongst UK ethnic minority children and those experiencing social adversity, populations which also have poor educational outcomes. We tested the hypothesis that asthma adversely affects performance in national school examinations in a large cohort from an area of ethnic diversity and social deprivation.
With a novel method (using patient and address-matching algorithms) we linked administrative and clinical data for 2002-2005 for children in east London aged 5-14 years to contemporaneous education and social care datasets. We modelled children's performance in school examinations in relation to socio-demographic and clinical variables. The dataset captured examination performance for 12,136 children who sat at least one national examination at Key Stages 1-3. For illustration, estimates are presented as percentage changes in Key Stage 2 results. Having asthma was associated with a 1.1% increase in examination scores (95%CI 0.4 to 1.7)%,p = 0.02. Worse scores were associated with Bangladeshi ethnicity -1.3%(-2.5 to -0.1)%,p = 0.03; special educational need -14.6%(-15.7 to -13.5)%,p = 0.02; mental health problems -2.5%(-4.1 to -0.9)%,p = 0.003, and social adversity: living in a smoking household -1.2(-1.7 to -0.6)%,p<0.001; living in social housing -0.8%(-1.3 to -0.2)% p = 0.01, and entitlement to free school meals -0.8%(-1.5 to -0.1)%,p<0.001.
Social adversity and ethnicity, but not asthma, are associated with poorer performance in national school examinations. Policies to improve educational attainment in socially deprived areas should focus on these factors.
哮喘有可能对儿童的学校考试成绩产生不利影响，进而影响他们未来的生活机会。在英国，少数民族儿童和那些面临社会困境的儿童哮喘发病率特别高，而这些人群的教育成果也较差。我们通过一项新的方法（利用患者和地址匹配算法），检验了哮喘是否会对一个民族多样化和社会贫困地区的大量儿童的国家学校考试成绩产生不利影响。
我们使用一种新颖的方法（利用患者和地址匹配算法），将 2002 年至 2005 年期间伦敦东部年龄在 5 至 14 岁之间的儿童的行政和临床数据与同期的教育和社会关怀数据集进行了关联。我们对社会人口统计学和临床变量与儿童学校考试成绩之间的关系进行了建模。该数据集捕获了至少参加过一次关键阶段 1-3 考试的 12136 名儿童的考试成绩。为了说明问题，我们给出了关键阶段 2 成绩的百分比变化估计值。患有哮喘的儿童的考试成绩提高了 1.1%（95%CI 0.4 至 1.7）%，p=0.02。成绩较差的儿童与孟加拉裔有关-1.3%（-2.5 至-0.1）%，p=0.03；有特殊教育需求的儿童-14.6%（-15.7 至-13.5）%，p=0.02；心理健康问题的儿童-2.5%（-4.1 至-0.9）%，p=0.003，以及社会劣势：生活在吸烟家庭中的儿童-1.2%（-1.7 至-0.6）%，p<0.001；生活在社会住房中的儿童-0.8%（-1.3 至-0.2）%，p=0.01，以及有资格获得免费校餐的儿童-0.8%（-1.5 至-0.1）%，p<0.001。
社会劣势和族裔，但不是哮喘，与国家学校考试成绩较差有关。改善社会贫困地区教育程度的政策应重点关注这些因素。
