Can use of healthcare services among 15–16-year-olds predict an increased level of high school dropout? A longitudinal community study

OBJECTIVES To study associations between healthcare seeking in 15-16-year-olds and high school dropout 5 years later. DESIGN Longitudinal community study. SETTING Data from a comprehensive youth health survey conducted in 2000-2004, linked to data from national registries up to 2010. PARTICIPANTS 13 964 10th grade secondary school students in six Norwegian counties. MAIN OUTCOME MEASURE Logistic regression was used to compute ORs for high school dropout. RESULTS The total proportion of students not completing high school 5 years after registering was 29% (girls 24%, boys 34%). Frequent attenders to school health services and youth health clinics at age 15-16 years had a higher dropout rate (37/48% and 45/71%), compared with those with no or moderate use. Adolescents referred to mental health services were also more likely to drop out (47/62%). Boys with moderate use of a general practitioner (GP) had a lower dropout rate (30%). A multiple logistic regression analysis, in which we adjusted for selected health indicators and sociodemographic background variables, revealed that seeking help from the youth health clinic and consulting mental health services, were associated with increased level of high school dropout 5 years later. Frequent attenders (≥4 contacts) had the highest odds of dropping out. Yet, boys who saw a GP and girls attending the school health services regularly over the previous year were less likely than their peers to drop out from high school. CONCLUSIONS Adolescents who seek help at certain healthcare services can be at risk of dropping out of high school later. Health workers should pay particular attention to frequent attenders and offer follow-up when needed. However, boys who attended a GP regularly were more likely to continue to high school graduation, which may indicate a protective effect of having a regular and stable relationship with a GP.