COD E R E D

Appendix EEducation and Health:A Review and AssessmentPrepared by Nancy Murray, Ph.D., Luisa Franzini, Ph.D.,, Dritana Marko, M.D.,Philip Lupo, Jr., M.P.H., Julie Garza, M.P.H., and Stephen Linder, Ph.D.Institute for Health PolicyThe University of Texas Health Science Center – HoustonAugust 2005EXECUTIVE SUMMARYThe interaction between education and health is both complex and cyclical. Health in childhoodaffects academic performance; while in adulthood, level of education has a lasting effect on healthprospects. A number of studies have attempted to elucidate parts of this interaction. Here, we considerthe evidence on how educational attainment affects health status in adults, but concentrate on thelinkages between chronic health conditions in children and their academic performance. Children ofparents with lower educational attainment tend to model the poorer health prospects of their parents. Asthese children become adults and have offspring of their own, a pattern or cycle develops. If we interveneupon the health of children through certain school-based programs, the negative cycle can be broken. Inother words, we improve not only children’s health, but also academic performance, and subsequentlyeducational attainment. This influences a life course that positively shapes the lives of future generations.School-BasedInterventionsAcademicPerformanceEducationalAttainmentChild HealthStatusAdult HealthStatusOur purpose is to scrutinize the scientific evidence behind these linkages as a basis forrecommending ways to make improvements in both health and education. Again, we focus oninterventions in childhood, specifically on those that are school-based. While there has been substantialattention to recommended ways to intervene during the school day – we list more than 100 from recentreports – surprisingly few have any documented impact on academic performance. The few that aresupported by scientific research will be highlighted.The report is divided into three parts. The first part addresses how health is linked to academicperformance. To assess this link adequately, we examine the most prevalent, chronic, health conditionsthat are thought to impair academic performance in children. Conditions assessed include overweightand obesity, asthma, diabetes, depression, epilepsy, sleep disorders and sickle cell anemia. Because ofour interest in non-medical, school-based interventions, much of our attention focuses on overweight,asthma and diabetes.