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Healthy Youth

Student Health and Academic Achievement

Health and Education Programs
Data & Statistics

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Physical Education and Academic Achievement in Elementary School*

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Coordinated School Health Programs and Academic Achievement* [pdf 279K]

The academic success of America’s youth is strongly linked with their health.

Health-related factors such as hunger, physical and emotional abuse, and chronic illness can lead to poor school performance.1 Health-risk behaviors such as substance use, violence, and physical inactivity are consistently linked to academic failure, and often affect students' school attendance, grades, test scores, and ability to pay attention in class.2-8

In turn, academic success is an excellent indicator for the overall well-being of youth and a primary predictor and determinant of adult health outcomes.9-13 Leading national education organizations recognize the close relationship between health and education, as well as the need to embed health into the educational environment for all students. 14-19

Health and Education Programs

Promoting academic achievement is one of the four fundamental outcomes of modern school health programs. Scientific reviews have documented that school health programs can have positive impacts on educational outcomes, as well as on health risk behaviors and health outcomes.20-28 Programs that are primarily designed to improve academic performance are increasingly being recognized as important public health interventions.29-31

The Healthy People 2010 Objective 7-1 calls upon the nation to increase high school completion rates to 90 percent because “dropping out of school is associated with delayed employment opportunities, poverty, and multiple social and health problems, including substance abuse, delinquency, intentional and unintentional injury, and unintended pregnancy.”32 Educational interventions, such as reduced class size, are associated with improved health outcomes, as well as improved educational outcomes.31

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Data & Statistics

The Youth Risk Behavior Surveillance System (YRBSS) monitors behaviors that contribute markedly to the leading causes of death, disability, and social problems among youth and adults in the United States. Through the national Youth Risk Behavior Survey, CDC monitors student health-risk behaviors and the extent to which these behaviors are associated with academic achievement.

There is a negative association between health-risk behaviors and academic achievement among high school students after controlling for sex, race/ethnicity, and grade level. This means that students with higher grades are less likely to engage in health-risk behaviors than their classmates with lower grades, and students who do not engage in health-risk behaviors receive higher grades than their classmates who do engage in health-risk behaviors. These associations do not prove causation. Further research is needed to determine whether low grades lead to health-risk behaviors, health-risk behaviors lead to low grades, or some other factors lead to both of these problems.

Overview of the Associations Between Health-Risk Behaviors and Academic Grades [pdf 141K]

Alcohol & Other Drug Use PDF 130K | PPT 441K
Sexual Risk Behaviors PDF 139K | PPT 142K
Tobacco Use PDF 155K | PPT 148K
Unhealthy Weight Control Behaviors & Physical Inactivity PDF 163K | PPT 172K
Unintentional Injury & Violence=Related Behaviors PDF 131K | PPT 237K

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  1. Dunkle MC, Nash MA. Beyond the Health Room. Washington, D.C.: Council of Chief State School Officers, Resource Center on Educational Equity; 1991.
  2. Dewey JD. Reviewing the relationship between school factors and substance use for elementary, middle, and high school students. The Journal of Primary Prevention 1999;19(3):177–225.
  3. Mandell DJ, Hill SL, Carter L, Brandon RN. The impact of substance use and violence/delinquency on academic achievement for groups of middle and high school students in Washington. Seattle, WA: Washington Kids Count, Human Services Policy Center, Evans School of Public Affairs, University of Washington; 2002.
  4. Swingle CA. The relationship between the health of school-age children and learning: implications for schools. Lansing, MI: Michigan Department of Community Health; 1997.
  5. Dake JA, Price JH, Telljohann SK. The nature and extent of bullying at school. Journal of School Health 2003;73(5):173–180.
  6. Shephard RJ. Habitual physical activity and academic performance. Nutrition Reviews 1996;54(4 Pt 2):S32–S36.
  7. Valois RF, MacDonald JM, Bretous L, Fischer MA, Drane JW. Risk factors and behaviors associated with adolescent violence and aggression. American Journal of Health Behavior 2002;26(6):454–464.
  8. Ellickson PL, Tucker JS, Klein DJ. Ten-year prospective study of public health problems associated with early drinking. Pediatrics 2003;111(5 Pt 1):949–955.
  9. Grossman M, Kaestner R. Effects of education on health. In: The Social Benefits of Education. Behrman JR, Stacey N, editors. Ann Arbor: University of Michigan Press; 1997.
  10. Harper S, Lynch J. Trends in socioeconomic inequalities in adult health behaviors among U.S. states, 1990–2004. Public Health Reports 2007;122(2):177–189.
  11. Lewallen TC. Healthy learning environments. ASCD INFOBrief; 2004(38). Available at:* 
  12. Vernez G, Krop RA, Rydell CP. The public benefits of education. In: Closing the Education Gap: Benefits and Costs. Santa Monica, CA: RAND Corporation; 1999:13–32. Available at: [pdf 8MB].* 
  13. Lewallen LP. Healthy behaviors and sources of health information among low-income pregnant women. Public Health Nursing 2004;21(3):200–6.
  14. Association for Supervision and Curriculum Development. The whole child and Health and Learning. ASCD Adopted Positions. 2004. Available at*
  15. Council of Chief State School Officers. Assuring school success for students at risk: A policy statement of the Council of Chief State School Officers. November 1987. Available at:* 
  16. Council of Chief State School Officers. Policy statement on school health. 2004. Available at: [pdf 87k].*
  17. National School Board Association. Beliefs and Policies of the National School Board Association. April 2007. 
  18. National Association of State Boards of Education. Public policy positions of the National State Boards of Education. 2006.
  19. American Association of School Administrators. AASA position statements. Position statement 3: Getting children ready for success in school, July 2006; Position statement 18: Providing safe and nurturing environment for students, July 2007. Available at: [pdf 106k].* 
  20. Murray NG, Low BJ, Hollis C, Cross AW, Davis SM. Coordinated School Health Programs and Academic Achievement: A Systematic Review of the Literature. Journal of School Health 2007; 77(9): 589–600.
  21. Society of State Directors of Health, Physical Education and Recreation. Making the connection: Health and student Achievement. Available at: [ppt 5.2MB].*
  22. Society of State Directors of Health, Physical Education and Recreation. Summary Research Documents for components of a Coordinated School Health Program. Available at:*
  23. Taras H. Nutrition and student performance at school. Journal of School Health 2005; 75(6): 199–213.
  24. Taras H. Physical activity and student performance at school. Journal of School Health 2005; 75(6): 214–218.
  25. Taras H, Potts-Datema W. Childhood asthma and student performance at school. Journal of School Health 2005; 75(8): 296–312.
  26. Taras H, Potts-Datema W. Chronic health conditions and student performance at school. Journal of School Health 2005; 75(7): 255–266.
  27. Taras H, Potts-Datema W. Obesity and student performance at school. Journal of School Health 2005; 75(8): 291–295.
  28. Taras H, Potts-Datema W. Sleep and student performance at school. Journal of School Health 2005; 75(7): 248–254.
  29. Freudenberg N, Ruglis J. Reframing school dropout as a public health issue. Preventing Chronic Disease 2007; 4(4):A107.
  30. National Middle School Association. Small schools and small learning communities: Position statement of the National Forum to Accelerate Middle Grades Reform. June 2004. Available at:* 
  31. Muenning P, Woolf SH. Health and economic benefits of reducing the number of students per classroom in US primary schools. American Journal of Public Health. 2007; 97:2020–2027.
  32. U.S. Department of Health and Human Services. Healthy People 2010: Understanding and Improving Health. 2nd ed. Vol. 1. Washington, D.C.: Government Printing Office; November 2000. Available at: [pdf 13M].
Links to non-Federal organizations are provided solely as a service to our users. Links do not constitute an endorsement of any organization by CDC or the Federal Government, and none should be inferred. The CDC is not responsible for the content of the individual organization Web pages found at this link.

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Page last reviewed: October 27, 2008
Page last modified: October 27, 2008
Content source: National Center for Chronic Disease Prevention and Health Promotion, Division of Adolescent and School Health

Division of Adolescent and School Health
National Center for Chronic Disease Prevention and Health Promotion
Centers for Disease Control and Prevention
Department of Health and Human Services