Children and Families Policy Research Unit


NIHR Children and Families Policy Research Unit


Chronic health conditions, school absence and attainment

Influence of health condition, social disadvantage and school on absenteeism and relationship with educational attainment (September 2021 - August 2023)

Research Team

Dr Matt Jay, Dr Lauren Herlitz, Dr Claire Powell, Professor Jess Deighton, Dr Ruth Blackburn, Professor Ruth Gilbert


Long-term conditions and disability

What we hope to find out

We aim to find out why some children with chronic health conditions do worse in their exams at schools than other children.

Why are we doing this study

There is ample evidence that children with chronic health conditions, on average, do worse in their school exams than children without chronic health conditions. Because we know that children with chronic health conditions are more likely to have more time off school, some scientists have suggested that school absence is a reason for poorer results.

However, we do not currently know if this is correct. Chronic health conditions can have other effects on learning, such as by affecting concentration, memory and other cognitive skills. Many conditions may also mean that children have difficulty communicating such as where language skills do not develop at the usual pace. Therefore, it may be the case that it is the chronic health condition itself that results in poorer attainment, not just more absence from school.

Why this is important

It is crucial that all children and young people get the support they need to succeed in school. Therefore, we need to understand the true causes of poorer attainment. This way, government, schools and health services will be better able to support young people with health conditions in school. For example, if school absence is the main cause, interventions to reduce absence should help in improving exam performance. However, if the cause lies in the chronic health condition itself, this implies that more work may be needed to support children in school in managing the effects of their condition.

What we will do

We will use the ECHILD dataset, which holds anonymised health and education data on 14 million people. This dataset brings together for the first time health and education data for all children in English state school and all those who attend NHS hospital services.

We will calculate the proportion of children in English schools with chronic health problems, and when they experience them. We will follow up groups of children and examine how much lower their grades are than expected. Because of the scale of the ECHILD database and the richness of data it contains, we will be able to use statistical causal analyses to determine how much of the relationship between chronic health conditions and exam results is determined by absence, the condition itself or other factors.