ses. some research suggests educational outcomes remain poorer in adults who experience childhood chronic illness, but financial outcomes do equalize with proper support. childhood chronic illnesses are common among school-aged children in the united states, and these illnesses often require management within school settings for a child to safely attend. at any stage, children with chronic illness can have reduced quality of life, especially if the children or their families are of low socioeconomic status. malnutrition is a greater risk among children with chronic illnesses, and children's physical and cognitive development may be poorly impacted, such as abnormal immune system regulation and decreased iq scores. adulthood childhood chronic illnesses and their sequelae persist into adulthood, such as in the case of asthma or diabetes. despite management of individual diseases, a diagnosis of chronic childhood disease generally does not resolve upon growth into adulthood. relatedly, experiencing a childhood chronic illness may lead to financial hardships later in life, as shown in childhood cancer survivors. society and culture impact on family members and caregivers the presence of a child with a chronic illness in the home has multiple effects on the family's life as it may affect daily routines. one potential consequence is the physical space inside the home being altered by the need for home health or medical equipment. as such children typically require frequent appointments, caregivers can feel strain to participate in their other children's lives equally and may develop increased levels of stress and family discord. caregivers report lower physical and psychological quality of life, and coping strategies are important in improving psychological quality of life, just as it is for the ill children themselves. healthy siblings of children with a chronic illnesses can have negative experiences and emotions, including withdrawal, overwhelm, and isolation even when social support is present. child life specialists and health professionals must provide additional support to facilitate proper psychosocial adjustment among healthy siblings, as they already do for ill children. the time requirements could also increase social isolation from extended family members. given the cost associated with the greater need for specialized treatments as well as decreased time to work, these families may also experience economic difficulties. societal impact childhood chronic illnesses can have large-scale implications for societies. one to two percent of healthcare budgets in developed countries is spent on asthma, the most common childhood chronic illness. while not specific to childhood disease, the cdc reports that 90% of the u.s. national spending on healthcare goes to chronic diseases broadly.