Comprehensive Challenges for the Well Being of Young Children: A Population-based Study of Publicly Monitored Risks in a Large Urban Center

This population-based study investigated the unique and cumulative relations between risks that are monitored by public surveillance
systems and academic and behavioral outcomes for an entire cohort of third graders in a large, urban public school system.
Using integrated, administrative records from child welfare, public health, housing, and education for a population of over
10,000 students, this study documented the disproportionate prevalence of early risks that included low birth weight or preterm
birth, inadequate prenatal care, teen mother, high lead exposure, low maternal education, child maltreatment, and homelessness.
Multiple logistic regression analyses demonstrated that low maternal education (i.e., mothers without a high school degree)
had the strongest association with third grade reading and math achievement, attendance, and school suspensions, controlling
for child demographics, poverty, and all other risks. Classroom behavior was significantly influenced by familial and social
risks (i.e., teen mother, low maternal education, homelessness, and maltreatment), but not biological risks (i.e., preterm
or low birth weight and high lead). The cumulative number of risk experiences was significantly related to both academic and
behavioral outcomes and was most strongly associated with school attendance problems. Implications of the study for national
child welfare and educational policy are discussed.