ArticleFrontiers in public health2025
Association between COVID-19 pandemic and school refusal among elementary school children in Japan: difference-in-differences analysis.
Article in Frontiers in public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Parental Low Education, Low Income, Deprivation and School Refusal Among Japanese Elementary School Students in First Grade: Results From A-CHILD Study.Child: care, health and development · 2026Article
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6 authors.
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Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic has been reported to have affected children's mental health. However, the impact of the COVID-19 pandemic on school refusal remains unclear. This study examined the association between the early stage of the COVID-19 pandemic and school refusal among elementary school children in Japan using the difference-in-differences approach. Methods: Data from the Adachi Child Health Impact of Living Difficulty study were used. We followed up with children without COVID-19 pandemic experience in the fourth grade in 2016 and the sixth grade in 2018 (control group, Results: Approximately 3.8 and 4.0% of students in the sixth grade in the control and COVID-19 groups, respectively, were school refusal. Change in the prevalence of school refusal from the fourth to the sixth grade in the control and COVID-19 groups was 2.4 and 2.0%, respectively. The difference-in-differences approach showed that the experience of the COVID-19 pandemic did not increase the risk of school refusal, which remained consistent even after performing propensity score matching. Conclusions: The early stage of the COVID-19 pandemic may not be associated with the risk of school refusal in elementary school children in Japan. A more long-term and comprehensive analysis is required to examine the full impact of the pandemic on school refusal.
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