Evidence map›Paper›PMID 41615329›Full record

ArticleChild: care, health and development2026

Parental Low Education, Low Income, Deprivation and School Refusal Among Japanese Elementary School Students in First Grade: Results From A-CHILD Study.

Atsuna Tokumoto, Nobutoshi Nawa, Aya Isumi, Tatsuhiko Anzai, Takeo Fujiwara

Abstract read
In one paragraph

Article in Child: care, health and development, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Atsuna TokumotoDepartment of Public Health, Institute of Science Tokyo, Tokyo, Japan.ORCID https://orcid.org/0009-0005-0920-8400
Nobutoshi NawaDepartment of Global Environmental Health, Institute of Science Tokyo, Tokyo, Japan.ORCID https://orcid.org/0000-0001-6785-7867
Aya IsumiDepartment of Health Policy, Institute of Science Tokyo, Tokyo, Japan.
Tatsuhiko AnzaiDepartment of Biostatistics, M&D Data Science Center, Institute of Science Tokyo, Tokyo, Japan.
Takeo FujiwaraDepartment of Public Health, Institute of Science Tokyo, Tokyo, Japan.ORCID https://orcid.org/0000-0002-1074-3954

Funding

Innovative Research Program on Suicide Countermeasures (IRPSC)Japanese Ministry of Health, Labour and Welfare H27-Jyunkankito-ippan-002Japanese Ministry of Health, Labour and Welfare H29-Seisaku-Shitei-004Japan Health Foundation GrantsJapan Society for the Promotion of Science 16H03276Japan Society for the Promotion of Science 16K21669Japan Society for the Promotion of Science 17J05974Japan Society for the Promotion of Science 17K13245Japan Society for the Promotion of Science 19H04879Japan Society for the Promotion of Science 19J01614Japan Society for the Promotion of Science 19K14029Japan Society for the Promotion of Science 19K14172Japan Society for the Promotion of Science 19K19309Japan Society for the Promotion of Science 19K19310Japan Society for the Promotion of Science 19K20109Japan Society for the Promotion of Science 20K13945Japan Society for the Promotion of Science 21H04848St. Luke's Life Science Institute Grants
6 · The paper itself

Abstract

backgroundSchool refusal has negative consequences throughout life. While parental education and child poverty are closely linked to school refusal, the mechanism by which parental low education influences school refusal in offspring remains unclear. This cross-sectional study examined the association between parental low education and several dimensions of child poverty (low income and deprivation) with school refusal among first grade (6-7 years old) elementary school students in Japan.

methodsData were obtained from the Adachi Child Health Impact of Living Difficulty (A-CHILD) study conducted in 2015, 2017, 2019 and 2021 in Adachi City, Tokyo, Japan (N = 13 258). Parental education was classified as none, one or both parents graduated from some college or more. Inability to afford essential items or service payments was used to measure deprivation. A multivariate logistic regression model was used for the analysis, adjusting for other sociodemographic characteristics.

resultsThe prevalence of school refusal was 3.1% (N = 416). We found a positive association between parental low education and school refusal after adjusting for covariates (OR = 1.40, 95% CI: 1.08, 1.82). The association was attenuated by further adjustment by low income and deprivation, which showed a higher risk of school refusal (OR = 1.45, 95% CI: 0.98, 2.13 and OR = 1.62, 95% CI: 1.25, 2.10, respectively). Low income and deprivation explained 9.2% and 39.4% of the association between parental low education and school refusal of the offspring, respectively.

conclusionsLower educational attainment of parents was a risk of school refusal from an early stage of mandatory education in Japan, which can be explained partially by low income and deprivation. Policymakers should be aware that school refusal from an early age is common in families with low socio-economic status and should proactively reach out to these parents.

Indexed as

ParentsPovertyStudentsChildCross-Sectional StudiesEast Asian PeopleEducational StatusFemaleHumansJapanLow Socioeconomic StatusMaleSchoolsSocioeconomic Factorsdeprivationlow incomeparental educationschool refusalsocio‐economic status

Identifiers

PMID41615329
PMCPMC12857594

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.