Published online March 2, 2009
PEDIATRICS Vol. 123 No. 3 March 2009, pp. 1073-1080 (doi:10.1542/peds.2008-0533)
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SPECIAL ARTICLE

Disparities in Academic Achievement and Health: The Intersection of Child Education and Health Policy

Kevin Fiscella, MD, MPHa and Harriet Kitzman, PhD, RNb

a Departments of Family Medicine, Community and Preventive Medicine, and Oncology, School of Medicine
b School of Nursing, University of Rochester, Rochester, New York

Recent data suggest that that the United States is failing to make significant progress toward the Healthy People 2010 goal of eliminating health disparities. One missing element from the US strategy for achieving this goal is a focus on gaps in child development and achievement. Academic achievement and education seem to be critical determinants of health across the life span and disparities in one contribute to disparities in the other. Despite these linkages, national policy treats child education and health as separate. Landmark education legislation, the No Child Left Behind Act of 2001, is due for Congressional reauthorization. It seeks to eliminate gaps in academic child achievement by 2014. It does so by introducing accountability for states, school districts, and schools. In this special article, we review health disparities and contributors to child achievement gaps. We review changes in achievement gaps over time and potential contributors to the limited success of the No Child Left Behind Act of 2001, including its unfunded mandates and unfounded assumptions. We conclude with key reforms, which include addressing gaps in child school readiness through adequate investment in child health and early education and reductions in child poverty; closing the gap in child achievement by ensuring equity in school accountability standards; and, importantly, ensuring equity in school funding so that resources are allocated on the basis of the needs of the students. This will ensure that schools, particularly those serving large numbers of poor and minority children, have the resources necessary to promote optimal learning.

Key Words: academic achievement • child development • minority health • school performance • socioeconomic factors

Abbreviations: NCLB—No Child Left Behind Act of 2001 • SES—socioeconomic status • HP—Healthy People

Accepted Jul 3, 2008.


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