Young adults with chronic illnesses have poorer educational, vocational and financial outcomes

Most young adults who grow up with chronic illness graduate high school and have employment, but those with cancer, diabetes, or epilepsy are significantly less likely than their healthy peers to achieve important educational and vocational milestones, according to a report in the March issue of Archives of Pediatrics and Adolescent Medicine.

"In the United States, despite the variation in estimates, it is generally accepted that as many as 12 percent of children have special health care needs, including physical and emotional problems," the authors write as background information in the article. "With improved medical care during the past 40 years, most children with chronic illnesses survive into adulthood."

Gary R. Maslow, M.D., of the University of North Carolina at Chapel Hill, and colleagues analyzed data from the National Longitudinal Study of Adolescent Health to examine young adult outcomes in a nationally representative group of young men and women in the U.S. growing up with a chronic illness. The sample included 13,236 young adults aged 18 to 28. Those with asthma or non-asthmatic chronic illness – cancer, diabetes mellitus, or epilepsy – were compared with individuals who did not have these conditions.

Sixteen percent of the young adults in the sample had asthma, and 3 percent had cancer, diabetes, or epilepsy.

"Most young adults with chronic illness graduated high school (81.3 percent) and currently had employment (60.4 percent)," the authors report. "However, compared with healthy young adults, those with non-asthmatic chronic illness were significantly less likely to graduate high school, ever have had employment, or currently have employment and were more likely to receive public assistance."

Young adults with non-asthmatic chronic illness also had significantly worse young adult outcomes on all measures than those with asthma. "The non-asthmatic chronic illness group was less likely to have graduated high school, to ever have had employment, and to currently have employment and more likely to receive support from SNAP [the Supplemental Nutrition Assistance Program], to receive SSI/disability insurance, and to live with a parent/guardian," the authors write.

The authors believe continued efforts are needed to support children growing up with chronic illness to become successful adults – especially interventions that target educational attainment and vocational readiness.

"Pediatricians can play a role in promoting successful young adult outcomes by recognizing that such patients are at increased risk for educational, vocational, and financial problems," they conclude.