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Exploring the relationship between education and academic ability in childhood with healthcare utilization in adulthood: findings from the Aberdeen Children of the 1950s (ACONF)
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Simon D S Fraser ,
Rhiannon Owen ,
Ann Berrington ,
Shantini Paranjothy,
Nisreen A Alwan
European Journal of Public Health, Volume: 35, Issue: 5, Pages: 903 - 909
Swansea University Author:
Rhiannon Owen
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© The Author(s) 2025. Published by Oxford University Press on behalf of the European Public Health Association. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (CC BY).
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DOI (Published version): 10.1093/eurpub/ckaf120
Abstract
We explored the association between education and academic ability in childhood and both outpatient appointments and hospital admissions in adulthood, accounting for adult factors, including long-term conditions. The analytical sample consisted of 7183 participants in the Aberdeen Children of the 19...
| Published in: | European Journal of Public Health |
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| ISSN: | 1101-1262 1464-360X |
| Published: |
Oxford University Press (OUP)
2025
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| Online Access: |
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| URI: | https://cronfa.swan.ac.uk/Record/cronfa69813 |
| Abstract: |
We explored the association between education and academic ability in childhood and both outpatient appointments and hospital admissions in adulthood, accounting for adult factors, including long-term conditions. The analytical sample consisted of 7183 participants in the Aberdeen Children of the 1950s. Three outcomes were measured using routine Scottish medical records over a five-year period (2004–2008): (1) ≥5 outpatient appointments, (2) ≥2 hospital admissions, or (3) ≥3 outpatient appointments plus ≥1 hospital admission. We constructed a childhood (age 6–11) education and academic ability domain and calculated predicted risk scores of the three outcomes for each cohort member. Nested logistic regression models investigate the association between domain predicted risk scores and odds of each of the three outcomes accounting for childhood confounders and self-reported adult mediators. Adjusting for childhood confounders, lower childhood education and academic ability were positively associated with ≥5 outpatient appointments (OR 1.03, 95% CI 1.01–1.05), ≥2 hospital admissions (OR 1.04, 95% CI 1.03–1.6), and ≥3 outpatient appointments plus ≥1 hospital admissions (OR 1.04, 95% CI 1.02–1.06). Accounting for adult mediators, associations remained statistically significant, but their effect sizes were reduced. When school leaving age was included in the model, the association between the exposure and all three outcomes were attenuated. Education and academic ability in early life may be related to the burden of multiple hospital admissions and outpatient appointments later in life. However, the age at which the participant left school seems to substantially mediate this relationship underscoring the positive impact of time spent in education. |
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| College: |
Faculty of Medicine, Health and Life Sciences |
| Funders: |
This study was a independent research funded by the National Institute for Health and Care Research (NIHR) Artificial Intelligence for Multiple Long-Term Conditions (AIM) ‘Multidisciplinary Ecosystem to study Lifecourse Determinants and Prevention of Early-onset Burdensome Multimorbidity (MELD-B)’ (reference number NIHR203988). |
| Issue: |
5 |
| Start Page: |
903 |
| End Page: |
909 |