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J Sch Health. 2014 Jan;84(1):40-8. doi: 10.1111/josh.12117.

Health and academic achievement: cumulative effects of health assets on standardized test scores among urban youth in the United States.

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Professor of Epidemiology and Public Health, (, Director, Social and Behavioral Sciences; Director, CARE (Community Alliance for Research and Engagement), Yale School of Public Health, 135 College St., Suite 200, New Haven, CT 06510.



The Institute of Medicine (2012) concluded that we must "strengthen schools as the heart of health." To intervene for better outcomes in both health and academic achievement, identifying factors that impact children is essential. Study objectives are to (1) document associations between health assets and academic achievement, and (2) examine cumulative effects of these assets on academic achievement.


Participants include 940 students (grades 5 and 6) from 12 schools randomly selected from an urban district. Data include physical assessments, fitness testing, surveys, and district records. Fourteen health indicators were gathered including physical health (eg, body mass index [BMI]), health behaviors (eg, meeting recommendations for fruit/vegetable consumption), family environment (eg, family meals), and psychological well-being (eg, sleep quality). Data were collected 3-6 months prior to standardized testing.


On average, students reported 7.1 health assets out of 14. Those with more health assets were more likely to be at goal for standardized tests (reading/writing/mathematics), and students with the most health assets were 2.2 times more likely to achieve goal compared with students with the fewest health assets (both p < .001).


Schools that utilize nontraditional instructional strategies to improve student health may also improve academic achievement, closing equity gaps in both health and academic achievement.


academic achievement; health assets; health behavior; nutrition; physical activity; preadolescence; risk factors; smoking

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