Student Health and Academic Achievement
The academic success of America’s youth is strongly linked with their
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
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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
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
Sexual Risk Behaviors
Unhealthy Weight Control Behaviors & Physical Inactivity
Unintentional Injury & Violence=Related Behaviors
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Dunkle MC, Nash MA. Beyond the Health Room. Washington, D.C.: Council of
Chief State School Officers, Resource Center on Educational Equity; 1991.
- Dewey JD. Reviewing the relationship between school factors and substance
use for elementary, middle, and high school students. The Journal of Primary
- 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.
- Swingle CA. The relationship between the health of
school-age children and learning: implications for schools. Lansing, MI:
Michigan Department of Community Health; 1997.
- Dake JA, Price JH, Telljohann SK. The nature and extent of bullying at
school. Journal of School Health 2003;73(5):173–180.
- Shephard RJ. Habitual physical activity and academic performance.
Nutrition Reviews 1996;54(4 Pt
- 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.
- 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.
- Grossman M, Kaestner R. Effects of education on health. In:
Benefits of Education. Behrman JR, Stacey N, editors. Ann Arbor: University
of Michigan Press; 1997.
- 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.
- Lewallen TC. Healthy learning
environments. ASCD INFOBrief; 2004(38). Available at:
- 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:
- Lewallen LP. Healthy behaviors and sources of health information among
low-income pregnant women. Public Health Nursing 2004;21(3):200–6.
- Association for Supervision and Curriculum Development. The whole child and
Health and Learning. ASCD Adopted Positions. 2004. Available at
- 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:
- Council of Chief State School Officers. Policy statement on school health. 2004. Available
- National School Board Association. Beliefs and Policies
of the National School Board Association. April 2007.
- National Association of State Boards of Education. Public
policy positions of the National State Boards of Education. 2006.
- 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:
- 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.
- Society of
State Directors of Health, Physical Education and Recreation. Making the
connection: Health and student Achievement. Available at:
- Society of State
Directors of Health, Physical Education and Recreation. Summary Research
Documents for components of a Coordinated School Health Program.
Available at: http://wg.thesociety.org/home/publications*
- Taras H. Nutrition and student performance at school. Journal of School Health 2005;
- Taras H. Physical activity and student performance at
school. Journal of School Health 2005; 75(6): 214–218.
- Taras H, Potts-Datema W. Childhood asthma and student performance at school. Journal of School
Health 2005; 75(8): 296–312.
- Taras H, Potts-Datema W. Chronic health
conditions and student performance at school. Journal of School Health 2005;
- Taras H, Potts-Datema W. Obesity and student performance
at school. Journal of School Health 2005; 75(8): 291–295.
- Taras H, Potts-Datema W. Sleep and student performance at school. Journal of School
Health 2005; 75(7): 248–254.
- Freudenberg N, Ruglis J. Reframing school
dropout as a public health issue. Preventing Chronic Disease 2007;
- National Middle School Association. Small schools and small learning communities:
Position statement of the National Forum to Accelerate Middle Grades Reform. June 2004. Available
- 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.
- 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:
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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