SEARCHSYSTEMATIC_REVIEWepidemiology, public health

systematic_review·epidemiology, public health, pediatrics, obstetrics and gynecology, systematic review·PMC10200977

The effect of school-entry age on health is understudied in low- and middle-income countries: A scoping review and future directions for research

SSM - Population Health · 8 authors, 8 centres

AI SUMMARY

FIDELITY 100%

This summary was generated by AI from a single paper. It has not been reviewed by a clinician and is not clinical advice. Verify against the source before acting on it.

AGENT 01 · STRUCTURED SUMMARY

TRACE TO SOURCE

“

TL;DR

It identified only eight studies, which generally found that starting school at a younger age relative to peers was associated with negative health outcomes like ADHD, risky behaviors, and adverse reproductive health outcomes.

Full summary

1,056 CHARS

This scoping review systematically identified eight quantitative studies published between 2017 and 2022 that examined the health effects of relative age for grade in middle-income countries. The studies, primarily observational with some quasi-experimental designs, assessed outcomes across neurodevelopment and mental health, sexual and reproductive health, non-communicable diseases, and nutrition. The central finding is that younger-for-grade children were generally at increased risk for diagnoses like ADHD, earlier sexual debut and cohabitation, adolescent pregnancy, and engagement in risky behaviors. The evidence for nutritional outcomes like overweight and stunting was mixed. A key limitation is the very small body of evidence, with no studies from low-income countries, and most research focused on specific regions like Türkiye. The findings suggest potential negative health consequences from earlier school entry in these settings, but more research, including studies with robust designs and broader geographic representation, is needed.

STUDY TYPE

systematic_review

SPECIALTY

epidemiology

SUMMARISED BY

AI pipeline

FIDELITY CHECK

100% · A

ORIGINAL PAPER

PMC10200977

The effect of school-entry age on health is understudied in low- and middle-income countries: A scoping review and future directions for research

SSM - Population Health

READ THE FULL PAPER

ABSTRACT

Abstract Background Substantive literature has assessed the impact of starting school at younger ages relative to peers on health in high-income countries (HICs), but there is little evidence from low- and middle-income countries (LMICs). Conclusions drawn from HICs may not apply to different education contexts and health threats. This study maps the empirical evidence on the effect of school-entry age on health in LMICs and identifies directions for future research. Methods We conducted a scoping review between August and September 2022 by systematically searching the health sciences, education, economics, psychology, and general sciences literature and included quantitative and qualitative studies. The exposure of interest was relative age for grade defined as starting or progressing through school at a younger or older age compared to peers who are in the same grade. We extracted key characteristics of included studies and summarized their findings. We categorized results into broad health domains which emerged a posteriori from our analyses of included studies, including neurodevelopment and mental health, sexual and reproductive health, non-communicable diseases, and nutrition. Findings We identified 8 studies from middle-income countries published between 2017 and 2022. Among those studies, we identified 3 quasi-experimental studies using data from Brazil, Mexico, and Vietnam, and 5 observational studies primarily from Türkiye. Children starting school earlier had an increased risk of being diagnosed with attention deficit hyperactivity disorder, earlier sexual debut and cohabitation, adolescent pregnancy, adolescent marriage, and engaged more frequently in risky behavior compared to children who started school later. Pregnant women who started school younger also had fewer prenatal care visits and experienced more pregnancy complications. Although most studies identified negative health consequences from starting school earlier, the evidence for nutritional outcomes, such as overweight and stunting, was mixed. No studies were identified from low-income countries. Conclusions Little is known about the health consequences of school-entry age in low-resource settings. Additional research is needed to investigate the impact of relative age for grade, whether and how these effects persist into adulthood, and to inform strategies that can offset potential disadvantages stemming from school-entry cut-off dates. Keywords: School-entry age, Relative age for grade, Human capital, Social epidemiology, Low- and middle-income countries

CITATION EXPORT

Janny Liao, Henning Schröder, Elliot K Chin et al.. The effect of school-entry age on health is understudied in low- and middle-income countries: A scoping review and future directions for research. SSM - Population Health. (2023). https://doi.org/10.1016/j.ssmph.2023.101423

AUTHORS

8 · 8 CENTRES

Janny Liao, Henning Schröder, Elliot K Chin, Muideen Owolabi Bakare, Ramaele Moshoeshoe, Mónica L Caudillo, Kerim M Munir, Jan-Walter De Neve

aHeidelberg Institute of Global Health, Faculty of Medicine and University Hospital, University of Heidelberg, Heidelberg, Germany
bHarvard College, Harvard University, Cambridge, MA, USA
cChild and Adolescent Unit, Federal Neuro-Psychiatric Hospital, Enugu, New Haven, Enugu State, Nigeria
dDepartment of Economics, National University of Lesotho, Lesotho
eDepartment of Sociology, University of Maryland, MD, USA
fDivision of Developmental Medicine, Boston Children's Hospital, Boston, MA, USA
gDepartment of Pediatrics, Harvard Medical School, Boston, MA, USA
hDepartment of Psychiatry, Harvard Medical School, Boston, MA, USA