We examined associations between academic grades and positive health behaviors, individually and collectively, among U.S. high school students.
Design
Cross-sectional study design.
Setting:
Data were from the 2017 national Youth Risk Behavior Survey. Response rates were 75% for schools, 81% for students, and 60% overall (n = 14,765 students).
Subjects
Youth in grades 9th–12th.
Measures
We focused on youth behaviors that can prevent or delay the onset of chronic health conditions. Seven dietary, 3 physical activity, 2 sedentary screen time, and 4 tobacco product use behaviors were assessed. Variables were dichotomized (0/1) to indicate that a score was given to the positive health behavior response (e.g.,, did not smoke cigarettes = 1). A composite score was created by summing each positive health behavior response among 16 total health behaviors.
Analysis
Multivariable logistic regression analyses for each individual health behavior, and a multivariable negative binomial regression for the composite score, were conducted with self-reported academic grades, controlling for sex, grade in school, race/ethnicity, and body mass index (BMI) categories.
Results
Controlling for covariates, students who reported mostly A’s had 2.0 (P < .001) more positive health behaviors; students who reported mostly B’s had 1.3 (P < .001) more positive health behaviors; and students who reported mostly C’s had .78 (P < .001) more positive health behaviors, compared to students who reported mostly D’s/F’s.
Conclusions
Higher academic grades are associated with more positive individual and cumulative health behaviors among high school students. Understanding these relationships can help inform efforts to create a healthy and supportive school environment and strive for health equity.
MichaelSLMerloCLBaschCEWentzelKRWechslerH. Critical connections: Health and academics. J Sch Health. 2015;85(11):740-758. doi:10.1111/josh.12309.
2.
RasberryCNTiuGFKannL. Health-related behaviors and academic achievement among high school students — United States, 2015. MMWR Morb Mortal Wkly Rep. 2017;66(35):921-927. doi:10.15585/mmwr.mm6635a1.
3.
BradleyBJGreeneAC. Do health and education agencies in the United States share responsibility for academic achievement and health? A review of 25 years of evidence about the relationship of adolescents’ academic achievement and health behaviors. J Adolesc Health. 2013;52(5):523-532. doi:10.1016/j.jadohealth.2013.01.008.
4.
BuschVLoyenALodderMSchrijversAJPvan YperenTAde LeeuwJRJ. The effects of adolescent health-related behavior on academic performance: A systematic review of the longitudinal evidence. Rev Educ Res. 2014;84(2):245-274. doi:10.3102/0034654313518441.
5.
RasberryCNLeeSMRobinL, et al.The association between school-based physical activity, including physical education, and academic performance: A systematic review of the literature. Prev Med. 2011;52(suppl 1):S10-S20. doi:10.1016/j.ypmed.2011.01.027.
6.
BurrowsTGoldmanSPurseyKLimR. Is there an association between dietary intake and academic achievement: A systematic review. J Hum Nutr Diet. 2017;30(2):117-140. doi:10.1111/jhn.12407.
7.
MorinAJRodriguezDFalluJSMaïanoCJanoszM. Academic achievement and smoking initiation in adolescence: A general growth mixture analysis. Addiction. 2012;107(4):819-828. doi:10.1111/j.1360-0443.2011.03725.x.
8.
JacksonLAvon EyeAWittEAZhaoYFitzgeraldHE. A longitudinal study of the effects of Internet use and videogame playing on academic performance and the roles of gender, race and income in these relationships. Comput Hum Behav. 2011;27(1):228-239. doi:10.1016/j.chb.2010.08.001.
9.
JacksonDBVaughnMG. Adolescent health lifestyles and educational risk: Findings from the monitoring the future study, 2010-2016. Am J Prev Med. 2019;57(4):470-477. doi:10.1016/j.amepre.2019.05.008.
BrenerNDKannLShanklinS. Methodology of the youth risk behavior surveillance system — 2013. MMWR Recomm Rep. 2013;62(RR-1):1-20.
12.
BrenerNDCollinsJLKannLWarrenCWWilliamsBI. Reliability of the youth risk behavior survey questionnaire. Am J Epidemiol. 1995;141(6):575-580. doi:10.1093/oxfordjournals.aje.a117473.
13.
BrenerNDKannLMcManusTKinchenSASundbergECRossJG. Reliability of the 1999 youth risk behavior survey questionnaire. J adolescent Health. 2002;31(4):336-342. doi:10.1016/s1054-139x(02)00339-7.
14.
HeJChenXFanXCaiZHuangF. Is there a relationship between body mass index and academic achievement? A meta-analysis. Public Health. 2019;167:111-124. doi:10.1016/j.puhe.2018.11.002.
15.
BinderDA. On the variances of asymptotically normal estimators from complex surveys. International Statistical Review / Revue Internationale de Statistique. 1983;51(3):279-292.
16.
BentonDBurgessN. The effect of the consumption of water on the memory and attention of children. Appetite. 2009;53(1):143-146. doi:10.1016/j.appet.2009.05.006.
17.
BaidenPTadeoSKPetersKE. The association between excessive screen-time behaviors and insufficient sleep among adolescents: Findings from the 2017 youth Risk behavior Surveillance System. Psychiatry Res. 2019;281:112586. doi:10.1016/j.psychres.2019.112586.
18.
MichaelSLLowryRMerloCCooperACHydeETMcKeonR. Physical activity, sedentary, and dietary behaviors associated with indicators of mental health and suicide risk. Prev Med Rep. 2020;19:101153. doi:10.1016/j.pmedr.2020.101153.
19.
Adelantado-RenauMMoliner-UrdialesDCavero-RedondoIBeltran-VallsMRMartínez-VizcaínoVÁlvarez-BuenoC. Association between screen media use and academic performance among children and adolescents: A systematic review and meta-analysis. JAMA Pediatr. 2019;173(11):1058-1067. doi:10.1001/jamapediatrics.2019.3176.
20.
SilveiraMLGreenVRIannacconeRKimmelHLConwayKP. Patterns and correlates of polysubstance use among US youth aged 15-17 years: Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study. Addiction. 2019;114(5):907-916. doi:10.1111/add.14547.
21.
BaschCE. Healthier students are better learners: high-quality, strategically planned, and effectively coordinated school health programs must be a fundamental mission of schools to help close the achievement gap. J Sch Health. 2011;81(10):650-662. doi:10.1111/j.1746-1561.2011.00640.x.
22.
WethingtonHRFinnieRKCBuchananLR. Healthier food and beverage interventions in schools: Four community guide systematic reviews. Am J Prev Med. 2020;59(1):e15-e26. doi:10.1016/j.amepre.2020.01.011.
23.
PiercyKLTroianoRPBallardRM. The physical activity guidelines for americans. JAMA. 2018;320(19):2020-2028. doi:10.1001/jama.2018.14854.
24.
ParuthiSBrooksLJD’AmbrosioC. Consensus statement of the american academy of sleep medicine on the recommended amount of sleep for healthy children: Methodology and discussion. J Clin Sleep Med. 2016;12(11):1549-1561. doi:10.5664/jcsm.6288.
25.
U.S. Department of Health and Human Services. Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Dept of Health and Human Services; 2012.
26.
U.S. Department of Health and Human Services.E-Cigarette Use Among Youth and Young Adults. A Report of the Surgeon General. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Dept of Health and Human Services; 2016.
27.
U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Dept of Health and Human Services; 2014.
HuangKYChengSTheiseR. School contexts as social determinants of child health: current practices and implications for future public health practice. Public Health Rep. 2013;128(Suppl 3):21-28. doi:10.1177/00333549131286s304.
30.
McKelveyLMEdgeNCMesmanGRWhiteside-MansellLBradleyRH. Adverse experiences in infancy and toddlerhood: Relations to adaptive behavior and academic status in middle childhood. Child Abuse Negl. 2018;82:168-177. doi:10.1016/j.chiabu.2018.05.026.
31.
SharifiMSequistTDRifas-ShimanSL. The role of neighborhood characteristics and the built environment in understanding racial/ethnic disparities in childhood obesity. Prev Med. 2016;91:103-109. doi:10.1016/j.ypmed.2016.07.009.
32.
National Academies of Sciences, Engineering, and Medicine. Communities in Action: Pathways to Health Equity. Washington (DC): National Academies Press; 2017. doi:10.17226/24624.
33.
National Academies of Sciences, Engineering, and Medicine. The Promise of Adolescence: Realizing Opportunity for All Youth. Washington (DC): National Academies Press; 2019. doi:10.17226/25388.
34.
National Academies of Sciences, Engineering, and Medicine. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington (DC): National Academies Press; 2019. doi:10.17226/25552.
35.
HahnRATrumanBI. Education improves public health and promotes health equity. Int J Health Serv. 2015;45(4):657-678. doi:10.1177/0020731415585986.
36.
LewallenTCHuntHPotts-DatemaWZazaSGilesW. The whole school, whole community, whole child model: A new approach for improving educational attainment and healthy development for students. J Sch Health. 2015;85(11):729-739. doi:10.1111/josh.12310.
37.
LiburdLC. After the bell rings: Looking beyond the classroom to reduce inequalities in educational achievement and health outcomes. J Public Health Manag Pract. 2019;25(6):581-583. doi:10.1097/phh.0000000000000978.
38.
CorcoranRPCheungACKKimEXieC. Effective universal school-based social and emotional learning programs for improving academic achievement: A systematic review and meta-analysis of 50 years of research. Educ Res Rev. 2018;25:56-72. doi: 10.1016/j.edurev.2017.12.001.
