The Interconnected Nature of Learning and Health

How children think and act when they are young impacts their health and well-being throughout their life. School-aged children spend a great deal of their lives interacting within the context of an educational environment. (AAP, 2016). It prepares them to succeed in future occupational, community and familial roles. Consequently, the extent to which children succeed or struggle in school can greatly affect all aspects of their lives.

Recent research in fields ranging from neurosciences and child development to epidemiology and public heath provide compelling evidence for the causal role[s]…” (Basch, 2010) that health and learning play for the other. The findings have served as an impetus to better understand children’s health and how it can change due to the normal course of development and contextual influences.

One study found that 45% of 4-6th graders have more than one health need impacting learning. These children are 4 times more likely to do poorly on standardized tests; 5 times more likely to do poorly in school overall. (Bevans et al., 2010) It is essential to identify key elements (bio-psycho-social educational) that put children most at risk, as well as those that serve as protective factors through this period and into adult life.

Most efforts to improve child and adolescent health typically have focused on interventions designed to address specific risk behaviors, such as tobacco, alcohol and drug use, violence and/or obesity.  However, the results from a growing number of studies suggest that a greater health and learning impact might be achieved by also enhancing protective factors that help children avoid multiple behaviors that place them at risk for adverse health and educational outcomes.

This is because risk and protective factors interact in a dynamic fashion. At any given moment in development many factors are interacting simultaneously. For most children, both risk and protective factors are constantly at work. Each factor has several facets: strength, duration and frequency. Multiple factors increase the odds of disorder. Overcoming risk factors leads to resilience (health and learning). Masten (2001)

risk-and-protective-factors                                                                                                                                                             (Carson, 2011)

Protective factors include: personal characteristics such as a positive view of one’s abilities and prospects for the future; a sense of belonging at school and with family; and behaviors such as active participation in school or physical activities. Enhancing protective factors may buffer children and adolescents from the potentially harmful effects of negative situations and events

In his paper on The Economics, Technology and Neuroscience of Human Capability (2007), James Heckman explores the modern literature on the economics of child development and the economics of health. He identifies ways to use technology to extract tangible evidence that links the areas that most determine human capability. Findings that could lead to “new channels of policy to remediate well documented health disparities.” These areas span human development, cognitive and non cognitive skills, as well as environmental and social and emotional influences.

More importantly, Heckman acknowledges the pivotal role learning has on health and well-being outcomes, “the child who is well nourished, physically active and well rested is likely to have advantages regarding cognition compared with the child with deficits in any of these areas. The child who has difficulty seeing, difficulty paying attention or is bullied at school will struggle to succeed academically and will feel less connected and engage with school. In turn, the child who is less connected and engaged with school will be less motivated to attend.”

As children enter school, some find it matches the way their brains work and learning is rewarding. However, others find learning to be a daily challenge. While school is designed for some children’s kind of minds (e.g., those with strengths in attention, memory, language, social skills), for others, it is a daily struggle. At no time in life are we required to expose our weaknesses more publicly than during the school years. Learning difficulties can be experienced at any age because expectations change as a child progresses through school.  In addition, children can spend years hiding their learning challenges in fear of not living up to the real or perceived expectations of their parents and teachers (or even themselves), which consequently manifests through a range of bio-psycho-social-emotional issues.

National studies suggest that positive learning experiences are not accessible to 35-40% of children at any given time. Many of these struggling students are NOT eligible for special services and so fall through the cracks.

Consider these student scenarios representing many of the children we have seen in our work at the Center for School Success. Brian has always seemed to have a natural aptitude for math, but now, at the end of middle school, his inability to memorize basic math facts and rules has affected his grades; he is beginning to wonder what is wrong with him. Sasha studies diligently and can explain everything she has learned, but freezes up when a test is put in front of her. She spends many test days absent from school. Kevin can’t sit still in class and always seems to be tinkering with something. If you put a broken mechanical device in front of him, like a radio or car part, he can fix it effortlessly. He is just biding his time in school, so he can graduate and work in his uncle’s auto repair business.

It has become evident that no single discipline is able to adequately address all of the conditions that may negatively influence educational and/or health disparities. Researchers and policy makers are beginning to recognize. (Bradley & Greene 2013), Telfair & Shelton (2012)   that a multi-factorial problem requires a multi-faceted approach. Therefore, consideration should be given to collaborative, community-based models that take into account the explicitly linked fields of health and learning.



American Academy of Pediatrics. (2016). Policy Statement: Role of the school nurse in providing school health services. Pediatrics, 137(6)

Basch, C.E. (2010). Healthier students are better learners: A missing link in school reforms to close the achievement gap. Equity Matters: Research Review No. 6. New York: The Campaign for Educational Equity

Bevans, K. B., Riley, A. W. and Forrest, C. (2010). Development of the Healthy Pathways Child-Report Scales. Quality of Life Research, 19,1195–1214

Bradley, B. & Greene, A. (2013). 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 Journal of Adolescent Health, 52(6). Retrieved from

Carson, S. (2011). “The History of Resilience Research” Lecture Harvard Extension School (January 4, 2011) Cambridge, MA.

Heckman, J.J. (2007). The economics, technology, and neuroscience of human capability formation. Proceedings of the National Academy of Sciences, 104, 13250-13255.

Masten, A. S. (2001). Ordinary magic: Resilience processes in development. American Psychologist, 56, 227–238.

Telfair, J. & Shelton, T.L. (2012). Educational attainment as a social determinant of health. N C Med J.,73(5),358-365.


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