Does academic achievement during childhood and adolescence benefit later health?

Abstract

Purpose: Educational disparities in health persist after adjustment for income and occupation, suggesting that other purely cognitive and psychosocial mechanisms may be involved. Unlike occupation- or income-mediated effects, effects of cognitive and psychosocial gains-as reflected in academic achievement-may be apparent even before schooling is completed.

Methods: We used data spanning 10 years on a national U.S. cohort of 2546 children aged 3-14 years at baseline to estimate the effects of academic achievement, measured by standardized tests of cognitive achievement, on future health. We used marginal structural models to address potential mutual influence of achievement and health on each other over time.

Results: One SD higher academic achievement 1997-2002 was associated with a lower prevalence of poorer health status in 2007 in girls (prevalence ratio = 0.87 [(95% confidence interval) 0.78-0.97]) but not in boys (prevalence ratio = 0.96 [0.86-1.08]). Higher achievement was also weakly associated with lower body mass index and less psychological distress among girls only.

Conclusions: Academic achievement may benefit future health but a number of questions remain unanswered, including reasons for the gender differences and how academic achievement-related health disparities may progress over the life course and interact with other social determinants of health.

Keywords: Academic achievement; Body mass index; Children and adolescents; Education; Gender; Health status; Marginal structural models; Mental health.

Figure 1

Assumed causal structure of health and academic achievement Academic achievement is assumed to be influenced by health at each time-point, and in turn to influence health at future time-points.

Figure 2

Study sample from Child Development Supplement (CDS) and Transition into Adulthood (TA) supplemental studies to the Panel Study of Income Dynamics, 1997–2007