Developing an index of educational risk from health and social characteristics known at birth

The goal of the work described in this report was to develop a new child health index that could be reported annually by the National Education Goals Panel for each of the 50 states, as well as for local areas. This index would serve as an indicator of health conditions at birth that relate to children's readiness to learn upon school entry. The new standard birth certificate adopted by nearly all states in 1989 contains more than a dozen items of information that are potentially useful for this purpose. The availability of these data make it possible to sum across the individual health factors to form a composite index made up of factors with demonstrated relevance to later educational performance for all children born in a given year in a given geographical area. In this paper, we describe the development of such an index. Our index consisted of six risk factors: late (third trimester) or no prenatal care, low maternal weight gain (<21 pounds), closely spaced birth (within 18 months of a previous birth to the same mother), three or more older siblings, mother smoked during pregnancy, or mother drank alcohol during pregnancy. In 1990, 55% of all births had none of these risk factors, while 14% had two or more of these risk factors. There were substantial variations by race and ethnicity on this index. American Indian births fared the worst with only 37% of such births having no risks and 28% having two or more risks. Asian births, on the other hand, had the best start on life with 62% of Asian births showing no risks and 11% showing two or more risks. To demonstrate the importance of the index to future school success, we analyzed data from the National Longitudinal Survey of Youth, predicting from birth characteristics to children's reading and vocabulary test scores at ages 4 and 5.