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Research Article

School types in adolescence and subsequent wellness and well-being in young machismo: An outcome-wide analysis

• Ying Chen,
• Christina Hinton,
• Tyler J. VanderWeele

x

• Published: November 10, 2021
• https://doi.org/10.1371/journal.pone.0258723

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Abstract

While past empirical studies have explored associations betwixt types of primary and secondary schools and student academic achievement, outcomes across academic performance remain less well-understood. Using longitudinal information from a accomplice of children (N = 12,288, hateful historic period = 14.56 years) of nurses, this study examined associations between the types of schools participants attended in adolescence and a broad range of subsequent psychological well-being, social engagement, character strengths, mental health, health behavior and concrete health outcomes. Results in this sample suggested little difference betwixt attention private contained schools and public schools across outcomes in young adulthood. At that place were, however, notable differences in subsequent outcomes comparison homeschooling and public schools, and mayhap some testify comparing religious schools and public schools. Specifically, there was some show that attending religious schools versus public schools was associated with a higher likelihood of frequent religious service omnipresence and condign registered voters, a lower adventure of overweight/obese, fewer lifetime sexual partners, and a higher risk of subsequently being binge drinkers; even so, these associations were not robust to correction for multiple testing. Homeschooling compared with public schooling was associated with subsequently more frequent volunteering (ß = 0.33, 95% CI = 0.15, 0.52), greater forgiveness (ß = 0.31, 95% CI = 0.16, 0.46), and more than frequent religious service attendance (Take chances Ratio [RR] = 1.51, 95% CI: one.27, 1.fourscore), and possibly likewise with greater purpose in life, less marijuana use, and fewer lifetime sexual partners, merely negatively associated with college degree attainment (RR = 0.77, 95% CI: 0.67, 0.88) and possibly with greater risk of posttraumatic stress disorder. These results may encourage pedagogy stakeholders to consider a wider range of outcomes beyond academic performance in decision-making.

Citation: Chen Y, Hinton C, VanderWeele TJ (2021) School types in boyhood and subsequent health and well-being in young adulthood: An issue-wide analysis. PLoS I sixteen(eleven): e0258723. https://doi.org/ten.1371/periodical.pone.0258723

Editor: Zila K. Sanchez, Universidade Federal de Sao Paulo, BRAZIL

Received: January 28, 2021; Accepted: October 4, 2021; Published: November 10, 2021

Copyright: © 2021 Chen et al. This is an open admission article distributed nether the terms of the Creative Commons Attribution License, which permits unrestricted utilise, distribution, and reproduction in whatever medium, provided the original author and source are credited.

Data Availability: The data that support the findings of this written report cannot be shared publicly because the authors do not own the data. Data are bachelor from the Channing Division of Network Medicine Institutional Data Admission Committee upon filing out a collaboration request class. Information including the procedures to obtain and admission data is described at https://www.nurseshealthstudy.org/researchers (email: nhsaccess@channing.harvard.edu). The authors did not have special access privileges that others could non asking.

Funding: This study was supported by the Templeton Foundation (grant #52125 and #61075, recipient T.J.Five) and the National Institutes of Wellness (grant CA222147, recipient T.J.V). The National Institutes of Health supported the Growing Up Today Study (grant U01 HL145386 and R01 HD057368) and the Nurses' Health Study Ii (grant U01 CA176726 and R01 CA67262). The funders had no function in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors take declared that no competing interests exist.

Introduction

Empirical studies evaluating educatee outcomes across various types of schools can inform decision-making among policy-makers, educators, parents and other education stakeholders [ane]. School experiences in chief and secondary schools may exist crucial for shaping individuals' developmental and well-being trajectories in after life [2], and shaping educatee well-being is arguably one of the of import aims of educational activity [3]. Information technology is, therefore, important to understand students' long-term achievements and well-beingness across unlike aspects of life when comparison diverse types of master and secondary schools. Such evidence would further empower decision making amidst policy-makers, educators, parents and other education stakeholders [1].

While at that place is considerable variation across individual schools, adolescent schooling tin can largely be divided into 4 types: public schools, individual independent schools, individual religious schools and dwelling schooling [4]. According to recent reports, amidst U.S. adolescents in 2016, approximately 87.0% attended public schools, 8.8% attended individual schools and 3.vi% were homeschooled [v]. Public schools are mainly funded and regulated by local governments to provide free education to every child [six,7]. In contrast, private schools primarily depend on private sources of funding (e.g., tuition, donation), are operated by private organizations that are either religiously or non-religiously affiliated, and have relatively high autonomy in conclusion-making such as pupil enrollment and curriculum development [6,7]. Homeschooling involves providing didactics at home, which is typically led past parents. Homeschooling tin can follow a predetermined curriculum (i.eastward., structured homeschooling), or self-directed natural learning without a fixed curriculum (i.e., unstructured homeschooling) [8,nine].

These dissimilar types of schools often prioritize dissimilar educational goals [9]. For case, schools may aim to back up students in developing academic knowledge, intrinsic motivation to larn, social skills and networks, civic appointment, a good for you lifestyle, well-being, good character, or a particular religious religion, with different schoolhouse types emphasizing each of these goals to greater or lesser extents [x,11]. It is arguably helpful for policy-makers, educators, parents and other education stakeholders to understand associations betwixt school types and student outcomes related to this wide range of educational goals [12–fourteen]. However, to date, the empirical evaluation of pupil outcomes across school types has, perhaps understandably, been based primarily on bookish accomplishment.

Empirical studies on schoolhouse types and student outcomes have well-nigh often used standardized test scores every bit the main outcome for evaluation. The findings from such studies are rather mixed overall [12], with some studies suggesting that students attending individual contained schools, private religious schools and structured homeschooling had modestly college standardized test scores on some disciplines equally compared to their peers at public schools [13–17], while other studies did not discover such bear witness [18–20].

Beyond academic achievement, studies examining school types and student outcomes related to other educational goals are sparse. There has been some prior research exploring diverse school types in relation to civic appointment and family formation outcomes, with some research suggesting that attending private contained schools and private religious schools is linked with greater civic appointment and more positive family unit outcomes than attending public schools [21–23], whereas some other research suggested piffling evidence of such differences [17]. In improver, there has been some prior research on homeschooling versus institutional schooling for a number of student outcomes, with homeschooling associated with greater civic engagement [24], less alcohol and drug use [25,26], better sleep [27], equal or better mental health and well-being [28–31] and equal or improve social-emotional skills [24,31,32]. While these studies have contributed to the literature, several methodological concerns remain. For instance, almost of these studies had small samples, limited covariate control, and used cross-sectional information, making information technology difficult to assess evidence for causal furnishings. More research is needed to gain a comprehensive understanding of associations between various school types and a various array of pupil outcomes, with longitudinal data and rigorous methodologies.

To address these gaps in the literature, we performed an outcome-broad longitudinal assay [33,34] to compare adolescents attending various types of schools in the years that followed across a broad range of outcomes in their young machismo, with extensive control of potential confounders (eastward.g., family socioeconomic status, family environment). The outcomes include multiple indicators of subsequent psychological well-being, social appointment, character strengths, mental health, health behavior and physical wellness outcomes.

Methods

Study population

This study used longitudinal data from the Nurses' Health Study II (NHSII) [35] and the Growing Up Today Written report (GUTS) [36]. Established in 1989, the NHSII accomplice enrolled 116,430 female registered nurses anile 25 to 42 years from across the U.South. In 1996, NHSII participants with children betwixt the historic period of 9 to fourteen years old were invited to accept their children participate in another cohort GUTS. Invitation messages and questionnaires were and so mailed to the children whose mother provided consent. Of them, 16,882 children returned the completed questionnaires at study baseline, thereby assenting to participate. Since so, NHSII and GUTS participants have been followed up through post or web-based questionnaires annually or biennially [35,36].

In this report, school types were assessed in the GUTS 1999 questionnaire wave (N = 12,288, hateful historic period = 14.56 years); thus, this yr was considered as the study baseline. Data on outcome variables were taken from the near recent GUTS questionnaire waves, primarily the 2010 questionnaire moving ridge (mean age = 25.x years); if the outcome was not assessed at the 2010 wave, we used data from the 2013 or 2007 wave; covariates were by and large assessed at or prior to the 1999 wave (S1 Tabular array provided the timeline regarding the measurements of all variables). Among participants of the 1999 questionnaire, i,025 individuals had missing data on school type, another 6,711 participants had missing data on at least one covariate (most covariates had less than 18% of missing data); depending on the result, another 681 to 1,510 participants had missing outcome data or were lost to follow-up. A multiple imputation procedure was used handle missing information on all variables. This yielded an analytic sample of 12,288 participants, with 2,432 of them beingness siblings (some families had multiple children enrolled). This study was canonical by the Institutional Review Board at the Brigham and Women's Hospital.

Exposure cess

School types.

Participants were asked to report the types of schools that they were attending in response to the question (GUTS 1999): "What type of school do you attend?" The responses were grouped into 4 categories including public schools, private independent schools, private religious schools, and abode schooled. Those who reported not in school or attending universities were excluded from all analyses.

Outcome assessment

A wide array of outcomes in young adulthood were assessed (primarily in 2010). Such outcomes included indicators of psychological well-beingness (i.due east., life satisfaction, positive affect, self-esteem, emotional regulation), social date (i.e., marital status, community engagement, religious service attendance, educational attainment), grapheme strengths (i.e., volunteering, sense of mission, forgiveness, civic engagement), mental health (i.east., low, anxiety, post-traumatic stress disorder [PTSD]), health behaviors (i.e., electric current smoking, binge drinking, marijuana or other illicit drug use, prescription drug misuse, number of lifetime sexual partners, early sexual initiation, history of sexually transmitted infections [STIs], brusk slumber duration, preventive healthcare apply), and concrete health (i.e., overweight/obesity, a number of physical health problems). Details on the measurement of all outcome variables were provided in the S1 Text.

Covariate assessment

Demographic characteristics.

Demographic covariates included participant age (in years), sex (male, female), race/ethnicity (non-Hispanic white, others), geographic region (West, Midwest, South, Northeastern), and puberty evolution (assessed with the tanner stage score) [36,37]. Maternal demographic covariates were besides considered including mother'south age (in years), race/ethnicity (non-Hispanic white, others), and marital status (married, others).

Family socioeconomic status (SES).

Multiple indicators of family socioeconomic condition were adjusted for including maternal subjective SES in the U.S. and in the community (both assessed with validated scales on a 10-point scale) [38], mother'south electric current employment status (currently employed, unemployed), male parent's educational attainment (high school or less, 2-twelvemonth college, four-year college, grad school, non-applicative), pretax household income (one: <$l,000, 2: $l,000-$74,999, 3: $75,000-$99,999, 4: ≥$100,000), census-tract college education rate (used as a continuous variable), and census-tract median income (1: <$50,000, 2: $50,000-$74,999, three: $75,000-$99,999, 4: ≥$100,000).

Family unit environment factors.

The post-obit baseline family environment factors were considered including participant family structure (live with both biological parents, live with a stepparent, others), family dinner frequency (never/sometimes, about days, everyday), religious service attendance (never, less than once/calendar week, at least once/week), maternal relationship satisfaction (retrospectively reported by GUTS participants, assessed with a nine-item validated scale measuring parent-child human relationship satisfaction) [39], maternal depression (yes, no), and maternal smoking status (never smoker, former smoker, current smoker).

Prior health status or health behaviors.

To reduce concerns about opposite causation, the following health characteristics at baseline were adapted for: depressive symptoms (assessed with the Depression Symptoms Scale of the McKnight Risk Factor Survey) [40], overweight/obesity (yes, no), current cigarette smoking (yeah, no), frequent binge drinking (yes, no), marijuana or other illicit drug use (yep, no), prescription drug misuse (yes, no), history of STIs (aye, no), history of early on sexual initiation (yeah, no), and the number of lifetime sexual partners (a continuous score).

Statistical analyses

All statistical analyses were performed in SAS nine.4 (tests of statistical significance were two-sided). Analysis of variance and Chi-square tests were used to examine baseline participant characteristics across school types.

In primary analyses, generalized estimated equation (GEE) models with independent covariance construction were used to regress each consequence on school types separately, adjusting for clustering by sibling condition. All continuous outcomes were standardized (hateful = 0, standard divergence = ane), so the effect estimates were reported in terms of standard deviations in the result variables. To account for multiple testing, Bonferroni correction was performed. All models controlled for sociodemographic characteristics, family surround factors, and health status and health-related behaviors at baseline. Because multiple imputation provides a more than flexible approach than many other methods of handling missing data [41–43], we performed multiple imputation by chained equations to impute missing information on all variables, with xx imputed datasets created. As a sensitivity analysis, we likewise reanalyzed the principal sets of models using consummate-instance analysis.

A number of other sensitivity analyses were performed. Showtime, because public school qualities are often influenced by commune- and state-level characteristics, nosotros reanalyzed the primary sets of models ane) stratified by neighborhood SES get-go, and then 2) restricting to participants from the 10 states with the highest and the 10 states with the lowest public school ranking [44] separately. Second, because some parents might send their children to religious schools for non-religious reasons [45], nosotros compared students attending religious schools versus public schools, stratified by their frequency of religious service omnipresence at baseline (considering at least in one case/calendar week of omnipresence as a proxy indicator for religiousness). Side by side, because religious faith is a major reason for homeschooling [vi], nosotros compared the habitation-schooled with those attending religious schools across the outcomes. Lastly, nosotros evaluated the extent to which the associations between schoolhouse types and various outcomes were robust to potential unmeasured confounding [46–48]. For this purpose, nosotros calculated East-values [47], which represent the minimum strength of clan that an unmeasured confounder(s) would demand to accept with both the exposure and the result variables on the take a chance ratio scale to fully explain abroad the exposure-outcome associations, above and across the measured covariates.

Results

Participant characteristics

At study baseline participant historic period range was 11–19 years, with a mean age of fourteen.56 years (SD = 1.62). The participants were higher pct female person, primarily not-Hispanic White, mostly had a loftier level of family SES, and were generally healthy (S1 Table). The majority reported attention public schools (80.56%), followed by individual religious schools (9.67%), private contained schools (8.12%), and homeschooling (1.66%). Compared to those at public schools, participants who attended private independent or religious schools generally had a higher level of family unit SES. Further, participants at religious schools or in homeschooling were more likely to nourish religious services, live with both biological parents, have family dinners frequently, and take lower rates of smoking, binge drinking, drug use, maternal depression or maternal smoking at baseline. Consistent with findings in other samples [49], homeschoolers in this sample were more common in the South and Midwest, and their mothers were less likely to be currently employed (Table one).

School types and subsequent health and well-beingness

There was lilliputian difference in subsequent outcomes between adolescents attending private independent schools versus public schools beyond diverse wellness and well-being outcomes examined, except for some bear witness that private schoolhouse students subsequently reported slightly college levels of forgiveness (β = 0.08, 95% CI: 0.02, 0.15), though the association did not pass the P<0.05 threshold subsequently Bonferroni correction for multiple testing (Table 2).

Equally compared to public schools, in that location was some evidence that students at religious schools afterwards had a higher likelihood of frequent religious service attendance and becoming registered voters, a lower risk of overweight/obesity and fewer lifetime sexual partners on average (east.g., β_{number of sexual partners} = -0.08, 95% CI: -0.xiv, -0.02); nevertheless, they were more likely to afterwards be frequent binge drinkers (e.thou., RR_{binge drinking} = one.15, 95% CI: 1.04, 1.27), though such associations again did not accomplish a p < .05 threshold afterward accounting for multiple testing (Tabular array two).

Compared to those attending public schools, homeschooled students were later on 51% more likely to attend religious services frequently (RR = 1.51, 95% CI: 1.27, 1.eighty), reported greater frequency of volunteering (β = 0.33, 95% CI: 0.15, 0.52), and had substantially higher levels of forgiveness on average (β = 0.31, 95% CI: 0.sixteen, 0.46), but were 23% less probable to attain a college degree (e.chiliad., RR _{achieve a college degree} = 0.77, 95% CI: 0.67, 0.88) in young adulthood; all of these associations also passed the p<0.05 threshold fifty-fifty after Bonferroni correction for multiple testing. There was also some bear witness that homeschooled students subsequently reported a higher level of sense of mission in life, lower risks of marijuana use and fewer lifetime sexual partners, but maybe had a higher risk of PTSD; these latter associations, all the same, passed conventional, but not Bonferroni-corrected, p-value thresholds (Tabular array ii).

Sensitivity analyses for unmeasured confounding

Due east-values [47] were calculated for assessing robustness of the observed associations to potential unmeasured confounding (Table 3). There was evidence, for case, that the associations of homeschooling with subsequent volunteering, forgiveness, religious service attendance, and educational attainment were at least moderately robust to unmeasured misreckoning. For instance, to fully explicate away the observed association between homeschool and volunteering above and across the measured covariates, an unmeasured confounder associated with both homeschooling and greater likelihood of volunteering by 2.04-fold each on the risk ratio scale could suffice, but weaker articulation confounder associations could non; and unmeasured confounding take a chance ratios of 1.54-fold for both volunteering and dwelling house-schooling could suffice to shift the confidence interval to include the null value, simply weaker joint confounder could non. Similarly strong Eastward-values were observed with homeschooling in relation to lower educational activity attainment, higher forgiveness, and greater religious service omnipresence. In contrast, for all comparisons of outcomes for public versus individual independent schools, and all comparisons of public versus religious schools, the E-values for the confidence interval were at about 1.24, and often considerably smaller, suggesting pocket-sized amounts of confounding could suffice to explicate away the observed divergence. The only moderately robust testify to potential unmeasured confounding was thus comparing public schools and homeschooling.

Table 3. Robustness to unmeasured confounding (E-values ^* ) for the associations between schoolhouse types and subsequent health and well-being (Growing Up Today Study [GUTS] from 1999 to 2007, 2010 or 2013 questionnaire moving ridge, N = 12,288).

https://doi.org/10.1371/journal.pone.0258723.t003

Other sensitivity analyses

First, reanalyzing the primary models using consummate-instance analyses yielded like results every bit the chief analyses (S2 Tabular array). Second, the analyses stratified by neighborhood SES also yielded similar results equally the primary analyses. Specifically, there was picayune difference betwixt private independent schools and public schools across outcomes among those residing in areas with either low (S3A Tabular array) or loftier (S3B Table) levels of census-tract median income; magnitudes of the effect estimates comparison religious versus public schools across outcomes were too similar to the chief analyses, simply the confidence intervals were wider due to the smaller sample size in each stratum (S3A and S3B Table). Next, the analyses restricting to participants from states with the lowest (S4A Table) and the highest public school rankings (S4B Table) once more plant trivial divergence between private and public schools in those states. Next, the sensitivity analyses stratified by frequency of religious service omnipresence suggested that the associations of religious schools (versus public schools) with greater likelihood of registered voting condition, fewer lifetime sexual partners and lower gamble of overweight/obesity, merely elevated risks of binge drinking were slightly stronger amongst those who attended religious services more frequently (S5 Table). Finally, the analyses comparing homeschooling to religious schools provided some suggestive testify that the homeschooled adolescents may volunteer more frequently and have a lower adventure of marijuana use in their immature machismo (S6 Tabular array).

Discussion

The nowadays study suggests that for the children of nurses who participated in this study, there was fiddling difference between attending individual independent schools versus public schools in subsequent health and well-existence outcomes in young adulthood. At that place was also merely small evidence for differences in subsequent outcomes when comparing private religious schools to public schools. In contrast, at that place was considerably greater prove that homeschooling versus public schools was positively associated with several outcomes (e.g., volunteering) but negatively associated with others (eastward.one thousand., educational attainment). Prior empirical studies comparing student outcomes across diverse types of schools have primarily used short-term standardized test scores as the outcome for evaluation. This report extends the literature by simultaneously examining multiple long-term wellness and well-being outcomes using longitudinal data. Beneath nosotros volition comment on relations to prior literature on this topic, only also on the particularities of the sample used in this report.

Consistent with some prior studies suggesting little or only pocket-size differences in exam scores comparison private and public school students [19], this study did not notice substantial differences in longer-term educational attainment (i.e. college caste). While outcomes beyond bookish achievement have been less often investigated, congruent with some of the strongest prior show [17], this report besides suggested little difference in social connection between private versus public school attendants. Likewise, consistent with some prior evidence [17], however opposite to other studies [21,22], this written report also plant little difference in subsequent borough engagement comparing private versus public school students. It is possible that private and public schools may differ in outcomes that were not examined in this study, such as students' subjective schooling experiences, opportunities for parental involvement and parental satisfaction [17]. It is also possible that there may be greater variations within, rather than between, these types of schools. For instance, some important factors that contribute to school performance such as instructor quality, teacher experience, and the availability of later on-school programs may vary considerably across individual schools [fifty].

This study plant but relatively modest health and well-being associations comparing attending religious schools versus public schools apropos overweight/obese and lifetime sexual partners. Attending religious schools was associated with a slightly college chance of frequent binge drinking in immature adulthood in this sample. This was surprising as prior inquiry has suggested that religious service omnipresence during babyhood and adolescence is associated with subsequently healthier behaviors in general [51]. However, it may be religious service attendance (rather than religious schooling) that is the principal commuter of the overall associations with religious upbringing. Our analyses adjusted for, and stratified by service omnipresence, while this has not ofttimes been accounted for in prior studies of religious schooling [fourteen]. Information technology is, therefore, possible that the associations between religious schooling and health in some prior studies may in fact reverberate confounding past religious service attendance, which once more evidence suggests is related to subsequent health and well-existence [51]. However, if service attendance is itself a office of religious schooling (and possibly the only source of service attendance for some students) then it is also possible that command for service attendance is over-adjustment and may in fact be an integral part of the effects of religious schooling. In any instance, the nowadays assay suggests that it may exist religious service omnipresence, however information technology is experienced, rather than other aspects of religious schooling that take the more substantial associations with outcomes subsequently in life, at to the lowest degree for the outcomes examined here. Religious knowledge and literacy, which may be the primary motivation for religious schooling for some parents, was not assessed in this study.

The largest differences in our study in subsequent outcomes were betwixt homeschooling and public schools. Congruent with prior studies [31], homeschoolers in this sample (versus those at public schools) were more probable to study subsequently greater character strengths and fewer risky health behaviors. Yet, homeschooled students were less probable to attain a college degree. While educational attainment may differ between structured and unstructured homeschooling [52], this written report did not have data on such subtypes and institute that, averaging across these subtypes, and overall homeschoolers had a lower likelihood of attaining a college degree in young adulthood. This may in part reflect lower attainment in learning or less interest in attending higher, but information technology may too reverberate the condition quo that some U.Southward. universities have restricted access policies for the homeschooled [53]. Reverse to prior evidence that homeschoolers (versus public school attenders) typically have equal or greater psychosocial and emotional well-being [31], this study suggested that homeschoolers may accept a higher risk of probable PTSD in young adulthood. These contrasting results might in office exist attributed to the longitudinal blueprint and the covariate control strategies in this study as compared to prior studies; we were examining outcomes in immature adulthood, rather than while the children were still at school and associations could potentially differ for outcomes assessed in the short-run versus the long-run.

In that location take been controversies over regulations apropos homeschooling and also over whether and what types of public-schoolhouse services should be made accessible to the homeschooled, with many of the discussions centered effectually academic resources and extracurricular activities [54,55]. With the growth in net use, homeschooling has becoming increasingly easier and more popular in the United States [5]. The Covid-xix pandemic has also forced some parents into dwelling house-schooling and this may itself alter long-term practices. Although the associations in our study warrant further investigation in future studies, the results here provide some suggestive evidence that back up for the psychological well-being of homeschoolers may exist worthwhile.

This study is subject to certain limitations. Commencement, the participants were by and large non-Hispanic White and were all children of nurses. Findings of this study may not be generalizable to other populations. Specifically, because all of the students were children of relatively well-educated mothers, this group may have been more able than most to ensure high quality schooling for their children regardless of schoolhouse type and also more than likely to change school type if the detail public or private or religious schools in their area were deemed to exist inadequate. The comparisons in this paper pertain to the schools attended past students in this particular sample; they are not comparisons across all U.S. schools. The findings may therefore be most relevant for families who are facing decisions and school dynamics relatively like to this sample, rather than representative of the full general U.South. population. Second, while there may be substantial variation within types of schools [50], we were unable to account for characteristics of individual schools due to the lack of information. Nevertheless, the homogeneous feature of this sample (all participants were the children of nurses) and the sensitivity analyses stratified by multiple sociodemographic characteristics helped reduce such concerns. 3rd, the diverse schoolhouse types can be further divided into subtypes that may be associated with different outcomes in certain cases [13,56], nosotros could non explore such subtypes here due to a lack of data. For instance, we could not examine charter schools separately, which are publicly funded schools with relatively loftier levels of autonomy in curriculum design, budgets and personnel hiring [57,58], though these are more common at present than when school type in this study was assessed. Likewise, we could not examine the subcategories of structured and unstructured homeschooling independently [8]. Further, the sample size of homeschoolers was relatively minor (due north = 187) in this study, which may have limited our statistical power. However, we however found associations between homeschooling and several outcomes, even with this more limited statistical power; moreover, we plant few differences among any of the other school types, even though the sample sizes were larger.

Despite these limitations, this written report provides important prove concerning associations between school types and a wide range of long-term outcomes. To our knowledge this is the first study that has prospectively examined a wide range of long-term health and well-beingness outcomes beyond multiple types of boyish schooling. Farther, this study rigorously deemed for a wide array of covariates that helps reduce concerns near potential confounding, option bias and reverse causation, which are major methodological concerns in prior studies [59].

Schoolhouse option is certainly shaped past a variety of factors, such equally beliefs, values, and logistical considerations, in addition to a desire for academic learning and educational achievement. A broad range of outcomes, considering numerous aspects of a child'due south long-term well-being, is therefore arguably relevant for controlling. The results of this report might thus help inform policy-makers, educators, parents and other education stakeholders in their decisions past consideration of the show on this broader range of educational goals and outcomes.

Supporting information

S3 Table.

A. School blazon in boyhood and subsequent health and well-being in immature adulthood, amongst those residing in low socioeconomic condition neighborhoods. B. Schoolhouse type in adolescence and subsequent health and well-being in young machismo, among those residing in loftier socioeconomic status neighborhoods.

https://doi.org/10.1371/journal.pone.0258723.s003

(DOCX)

S4 Table.

A. School type in adolescence and subsequent health and well-beingness in young adulthood, among those residing in the top 10 states with the lowest public school ranking. B. School type in adolescence and subsequent health and well-existence in young adulthood, amid those residing in the top 10 states with the highest public school ranking.

https://doi.org/10.1371/journal.pone.0258723.s004

(DOCX)

Acknowledgments

Nosotros give thanks the Channing Division of Network Medicine, Section of Medicine, Brigham and Women'southward Hospital, and Harvard Medical School for their back up in conducting this study.

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