Young children learn, in part, through active engagement. Therefore, it is important for them to be generally healthy. At kindergarten entry, 85 percent of children are rated as being in very good to excellent health by their parents. Also, these children demonstrate higher reading and mathematics knowledge and skills in the spring of kindergarten and the spring of first grade than children who are rated as being in less than very good health (i.e., they have significantly higher t-scores). Children reported to be in very good to excellent health as they enter kindergarten ("healthier children") are more likely to score in the top 25 percent in reading and mathematics in the spring of kindergarten and the spring of first grade than children in less than very good health.

Further, healthier children are more likely than children in less than very good health to understand the letter-sound relationship at the beginning and ending of words by the spring of kindergarten. Healthier children are also more likely than children in less than very good health to recognize words by sight and understand words in context by the spring of first grade (figure 10, table 8).

Children's general health also relates to their mathematics achievement. Children reported to be in very good to excellent general health as they enter kindergarten are more likely to demonstrate greater proficiency in ordinality/sequence and addition/subtraction by the spring of kindergarten than children in less than very good health. Also, by the spring of first grade, healthier children are more likely to be proficient in addition and subtraction and multiplication and division than children who are in less than very good health when they started kindergarten.