Original article
Growing Up With a Chronic Illness: Social Success, Educational/Vocational Distress

https://doi.org/10.1016/j.jadohealth.2010.12.001Get rights and content

Abstract

Objectives

We compared adult educational, vocational, and social outcomes among young adults with and without childhood-onset chronic illness in a nationally representative U.S. sample.

Methods

We used data from Wave IV (2008) of the National Longitudinal Study of Adolescent Health. We compared respondents who reported childhood-onset cancer, heart disease, diabetes, or epilepsy with young adults without these chronic illnesses in terms of marriage, having children, living with parents, romantic relationship quality, educational attainment, income, and employment. Multivariate models controlled for sociodemographic factors and adult-onset chronic illness.

Results

As compared with those without childhood chronic illness, respondents with childhood chronic illness had similar odds of marriage (odds ratios [OR] = .89, 95% CI: .65–1.24), having children (OR = .99, 95% CI: .70–1.42), and living with parents (OR = 1.49, 95% CI .94–2.33), and similar reports of romantic relationship quality. However, the chronic illness group had lower odds of graduating college (OR = .49, 95% CI: .31–.78) and being employed (OR = .56, 95% CI: .39–.80), and higher odds of receiving public assistance (OR = 2.13, 95% CI: 1.39–3.25), and lower mean income.

Conclusions

Young adults growing up with chronic illness succeed socially, but are at increased risk of poorer educational and vocational outcomes.

Section snippets

Data

Data were taken from Waves I and IV of Add Health. Add Health is a nationally representative sample of U.S. adolescents enrolled in grades 7–12 in the 1994–1995 school year (Wave I). Add Health sampling procedures and study design are described in detail elsewhere [25]. Our analytic sample consisted of respondents who participated in Wave I (1994–1995) and Wave IV (2008) in-home interviews (n = 15,701), had valid sample weights, and had complete data on primary outcomes of interest (n =

Participants

Sample characteristics are presented in Table 1. At Wave IV, respondents were aged between 24 and 32 years, with a mean age of 28.8 years (SD = .1). Approximately 2% of respondents reported a childhood-onset chronic illness and 3% reported adult-onset chronic illness. Most respondents with childhood-onset chronic illness had epilepsy (44%) or diabetes (24%). Fewer reported diagnosis of heart disease (18%) or cancer (16%). For those with adult-onset chronic illness, more than half had diabetes

Discussion

In this nationally representative sample, we found that the majority of young adults in the United States with childhood-onset chronic illness do well educationally, vocationally, and socially. However, although young adults with childhood-onset chronic illness do not differ on the social outcomes examined, they do fare worse than young adults without chronic illness on educational, vocational, and income outcomes, with half the odds of graduating college and having a current a job, and

Conclusions

With advances in pediatric medicine continuing to extend the lives of children with previously fatal childhood-onset conditions, there will be an increasing number of young adults with childhood-onset chronic illness. The surprising social success of young adults with childhood-onset chronic illness warrants further study because this may reflect social services already provided in hospitals and clinics or other unknown support mechanisms. Although the majority of young adults with

Acknowledgments

This research used data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill, and funded by grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 23 other federal agencies and foundations. Special acknowledgment is due to Ronald R. Rindfuss and Barbara Entwisle for

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