To investigate the association between caregiver-reported health-related discrimination and academic performance and school absenteeism in children with congenital heart disease (CHD), independent of bullying exposure.
Approach:
Study Design: Analysis of publicly available, de-identified data from the 2022–2023 National Survey of Children’s Health (NSCH) involving over 54,000 families.
Participants: Children aged 6–17 years with caregiver-reported CHD were included, operationalized as a diagnosis present at birth.
Outcomes: Primary outcome was academic performance categorized as excellent, good, or poor; secondary outcome was school absenteeism defined as missing 11 or more school days.
Covariates: Included child-level factors (age, sex, BMI), socioeconomic measures (race/ethnicity, household composition, caregiver education, income), and healthcare utilization variables.
Statistical Analysis: Bivariate analyses compared outcomes between children with and without health-related discrimination; multivariable analyses used ordinal and logistic regression.
Key Findings:
Children with CHD who experienced health-related discrimination had poorer academic performance compared to those who did not.
Health-related discrimination was associated with increased school absenteeism.
The effects of discrimination on academic outcomes were independent of bullying exposure.
Interpretation:
Health-related discrimination negatively impacts educational outcomes in children with CHD, highlighting the importance of addressing such discrimination in clinical and educational settings.
Limitations:
The study relied on caregiver reports, which may introduce bias.
The cross-sectional nature of the data limits causal inferences.
Conclusion:
Health-related discrimination is a significant factor affecting academic performance and absenteeism in children with congenital heart disease.
