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Evidence that disaggregates the influence of physical and mental health conditions on educational attainment, using population wide linked administrative data, varies between UK jurisdictions, with a lack of such research evident in Northern Ireland (NI). This study aims to address this gap by investigating the impact of students\u2019 physical and mental health on post-primary attainment in NI. This is a pertinent area as the recent Children and Young People\u2019s Emotional Health and Wellbeing in Education Framework outlined the need for cross-departmental collaboration between education and health.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Using administrative data that linked the household Census (2011), School Leavers Survey (2010\u20132014) and School Census (2010\u20132014), this study examines the associations between young people\u2019s GCSE attainment, physical health and mental health (<jats:italic>n<\/jats:italic>\u2009=\u200961,373). Multilevel models were executed to account for the nested data structure and wider demographic profile of young people. Interaction terms were also tested between factors such as sex, socio-economic background, and physical and mental ill-health markers to determine their effects on attainment.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The study confirmed the negative associations between lower post-primary attainment and \u2018very bad\u2019 self-reported health status (<jats:italic>d =<\/jats:italic> -1.01, 95% CI: -1.26, -0.75), the presence of a physical health condition (<jats:italic>d =<\/jats:italic> -0.39, 95% CI: -0.41, -0.36), mental health condition (<jats:italic>d =<\/jats:italic> -0.91, 95% CI: -1.00, -0.82) and an illness\/disability that limited daily activity a little (<jats:italic>d =<\/jats:italic> -0.48, 95% CI: -0.53, -0.44) or a lot (<jats:italic>d =<\/jats:italic> -0.98, 95% CI: -1.04, -0.92). Interaction terms were tested, and significant associations were evident between sex and physical health condition, sex and mental health condition, free school meal eligibility and physical health condition, and the presence of both a physical health condition and mental health condition.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>This study is the first instance where population wide, linked administrative data is used to examine the associations between educational attainment and students\u2019 physical and mental health in NI. The importance of mental health and the greater educational disadvantage some social groups may experience are key implications for policy.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12889-025-23780-3","type":"journal-article","created":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T08:34:44Z","timestamp":1755851684000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Healthy lives, enriched minds: the role of physical health and mental health on educational attainment in Northern Ireland"],"prefix":"10.1186","volume":"25","author":[{"given":"Erin","family":"Early","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Miller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Dunne","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dermot","family":"O\u2019Reilly","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,8,22]]},"reference":[{"key":"23780_CR1","unstructured":"World Health Organisation (WHO). 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The analysis was based on de-identified population level data and the data was supplied for the sole purpose of this project. The study received ethical approval from the Medicine, Health and Life Sciences Faculty Research Ethics Committee at Queen\u2019s University Belfast (Reference Number: PREC 16.05).Informed consent to participate in the study was deemed unnecessary according to national regulations. The lawful basis for processing personal data falls under the\u00a0Public Interest Article 6.1.E of the Data Protection Act 2018.The dataset used in this study consists of three administrative data sources in Northern Ireland (Census, School Leavers Survey and School Census). It is a legal requirement for the population to complete the Census every ten years. Schools are legally required by the Department of Education to annually complete the School Leavers Survey and School Census. These data were linked and made available to the research team as an anonymised dataset through Northern Ireland Statistics and Research Agency.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"2886"}}