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Poor teens may get more than academics at top schools; less risky health behaviours seen, too

CHICAGO - Disadvantaged teens may get more than an academic boost by attending top-notch high schools — their health may also benefit, a study suggests.

Risky health behaviour including binge-drinking, unsafe sex and use of hard drugs was less common among these kids, compared with peers who went to mostly worse schools. The teens were otherwise similar, all from low-income Los Angeles neighbourhoods who applied to top public charter schools that admit students based on a lottery system.

The researchers compared behaviour in almost 1,000 kids in 10th through 12th grade who were admitted to the high-performing schools and in those who went elsewhere. Overall, 36 per cent of the selected kids engaged in at least one of 11 risky behaviours, compared with 42 per cent of the other teens.

The study doesn't prove that the schools made the difference and it has limitations that weaken the results, including a large number of students who refused to participate. Still, lead author Dr. Mitchell Wong said the results echo findings in less rigorously designed research and they fit with the assumption that "better education will lead to better health." Wong is an internist and researcher at the University of California, Los Angeles.

The study involved mostly Latino students who applied to one of three top-performing public charter schools from 2007 to 2010. About half of the kids had parents who didn't graduate from high school and most didn't own their own homes.

Results were published online Monday in Pediatrics.

Teens were given computerized questionnaires to answer in private, to improve the chances for accurate self-reporting. Standardized test scores were obtained from the California Department of Education.

The results aren't a referendum on charter schools but the lottery system they use for enrolment made the comparison fairer, Wong said.

Despite the limitations, the study "is a beautifully conducted natural experiment" that could occur because there's more demand for high-performing schools than there is space available, said Kelli Komro, a professor of health outcomes and policy at the University of Florida in Gainesville. She was not involved in the research.

Because the Los Angeles schools' lottery system selects students randomly, not on grades or other differences, the study design "mimics a randomized controlled trial, the gold standard in health research," Komro said.

Most of the selected kids chose to attend those schools, while 83 per cent of those not picked went to schools with worse performance records. Math and English scores after freshman year were higher in selected kids than the other teens. Moreover, just 9 per cent of the selected kids dropped out of school, versus almost 1 in 4 of the others.

Prof. Harold Pollack, a University of Chicago public health researcher, said the study is important and highlights the challenge — and need to — create "a much larger number of schools that serve kids well."

Pollack said better academic performance among the charter school kids is likely more important for their long-term health than their risky behaviour choices.

"Educational outcomes are just so critical for people's well-being," he said.

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Online:

Pediatrics: http://www.pediatrics.org

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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

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