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Implications. Given the current prevalence of overweight conditions among children and the finding thatas children age their later weight depends primarily on their earlier weight (Kelder et al., 2002), by the timethey reach high school, we can expect that between a quarter and a third of them will be more likely to beheld back a grade, consider themselves poor students and expect to quit school based on their overweightstatus. These inferences project current trends forward in time, assuming nothing interferes with them.The only way to be sure of them is to track children’s weight status carefully as they progress from gradeschool into high school.AsthmaPrevalence. Asthma is another chronic health condition in childhood that has grown in prevalence overtime, with research documenting an increasing impact on child health, academic performance and familyfunctioning. The National Health Interview Survey conducted in 2002 revealed that 9 million U.S. childrenunder the age of 18 have been diagnosed with asthma during their lifetime; that is 12% of U.S. children.More than 4 million children experienced an attack in the last 12 months (National Health InterviewSurvey, 2002). A recent telephone survey of 1,500 households in the South Plains/Panhandle region ofTexas indicated that 15% of children had been diagnosed with asthma by a physician (Arif et al., 2004).Also in Texas, 10,500 children were admitted to a hospital for treatment of asthma in 2001; that is 170.1admissions per 100,000 population (Texas Health Care Information Council, 2003). The 10,500 figuremay underestimate the number of children living in Texas with the consequences of asthma, especiallypoorly managed asthma. Asthma surveillance in children is limited by issues of diagnostic criteria andaccess to health care, resulting in limited data on the prevalence of asthma. These difficulties contributeto unreliability in the estimates. For a clearer indication of these limitations, see Table 1.Asthma and Academic Performance. Studies of the impact of childhood asthma on school functioninghave examined academic achievement, school absences, sleep disturbances, and restriction of physicalactivity and have made an effort to include physician-diagnosed and undiagnosed asthmatics. A recentstudy in North Carolina, in which 2,059 students from 25 of 30 middle schools in one district weresurveyed about symptoms of asthma with the aid of a video depicting symptoms of asthma, found that 9%of the adolescents reported physician-diagnosed asthma with current symptoms and 27% reportedwheezing but no diagnosis of asthma (Yeatts & Shy, 2001). Furthermore, physician-diagnosed asthmaticsand “wheezers” were significantly more likely (2.6 and 1.8 times) to have missed school days thanasymptomatic students and were substantially more likely (7.8 and 4.7 times) to report sleep disturbances.More than one-third of these students (36%) experienced functional consequences of asthma that arelikely to negatively impact academic performance. The majority of these (27%) were efforts to cope withasthmatic symptoms without treatment.Joseph, Foxman, Leickly, Peterson, and Ownby (Joseph et al., 1996) conducted a study in Detroitin 1993, similar to the Yeatts and Shy study mentioned above, but undiagnosed asthmatics were identifiedthrough pulmonary function testing. Of the 230 third- through fifth-graders participating, 17.4% reportedphysician-diagnosed asthma and 14.3% were identified as undiagnosed asthmatics. Children who metsymptom criteria were 7.1 times more likely to report sleep disturbances and 15 times more likely to missphysical education classes, than children without asthma. Children with physician-diagnosed asthmamissed significantly more days of school than children without asthma. Undiagnosed asthmatics in thisstudy typically missed 6 or more days of school.Maier, Arrighi, Morray, Llewllyn, and Redding’s 1995 study in Seattle (Maier et al., 1998) of 4,995parents of first and second grade students found 11.5% of their sample to have physician-diagnosedasthma, and another 7.3% with current wheezing but no diagnosis. Compared to the asymptomaticpopulation, both diagnosed and undiagnosed children reporting symptoms of asthma were 6 times morelikely to miss school and 2 times more likely to experience sleep loss due to respiratory-related problems.An analysis of data from the 1988 National Health Interview Survey on Child Health gatheredinformation from parents on 10,362 children in grades 1 through 12 (Fowler et al., 1985). Of theseE-5