title: Does academic achievement during childhood and adolescence benefit later health?
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Epidemiology, University of Michigan, Ann Arbor. Electronic address: felicele@umich.edu.
authors.forename: Félice
authors.initials: F
authors.lastname: Lê-Scherban
authors.affiliation: Department of Epidemiology, University of Michigan, Ann Arbor.
authors.forename: Ana V
authors.initials: AV
authors.lastname: Diez Roux
authors.affiliation: Department of Biostatistics, University of Michigan, Ann Arbor.
authors.forename: Yun
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Epidemiology, University of Michigan, Ann Arbor; Department of Environmental Health Sciences, University of Michigan, Ann Arbor.
authors.forename: Hal
authors.initials: H
authors.lastname: Morgenstern
mesh_terms: D000124:Achievement; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004521:Educational Measurement; D004522:Educational Status; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D015233:Models, Statistical; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult
keywords: Academic achievement; Body mass index; Children and adolescents; Education; Gender; Health status; Marginal structural models; Mental health