BACKGROUND: Youth with chronic health conditions face challenges that may prevent them from achieving their educational goals.

PURPOSE: This dissertation examined whether children and adolescents with chronic health conditions were more likely to have poor educational attainment compared to youth without chronic health conditions. It examined the impact of type and onset of chronic health conditions as well as youth limited by chronic health conditions on educational attainment. The potential influences of mediating and moderating factors were also investigated.

METHODS: Using data from the National Longitudinal Study of Youth - Cohort 1997, multivariate logistic regression models were fit to examine the associations between type, onset of chronic health conditions, as well as youth limited by chronic health conditions and their impact on educational attainment. The cohort's sample size was 8,984 and participants were followed up through 2009. Chronic health conditions were defined by the 1997 parent questionnaire and the 2002 youth questionnaire. Educational attainment was defined by completion of high school by 21 years of age. Academic, psychosocial, neighborhood and school factors were examined and potential mediators and effect modifiers were identified.

RESULTS: The odds of poor educational attainment for youth who reported ever having a chronic health condition were significantly higher compared to youth who never reported a chronic health conditions, OR: 1.47 (95% CI: 1.22 - 1.76). Specifically youth with cancer, diabetes or epilepsy had the highest odds of poor educational attainment, OR: 1.96 (95% CI: 1.13 - 3.37). There were similar associations for youth limited by a chronic health condition, OR: 1.76 (95% CI: 1.33 - 2.34) and for youth with early onset of a condition, OR: 1.61 (95% CI: 1.29 - 1.99). Academic and psychosocial variables attenuated these associations and mediators were present. Interactions with school-level factors and chronic health conditions were also found.

CONCLUSIONS: Youth with chronic health conditions, specifically those with cancer, diabetes or epilepsy, youth limited by or have early onset of a chronic health condition are at particular risk of poor educational attainment. There are strategies that may mitigate these associations such as depressive symptoms screenings and support services in school.