Early childhood lead exposure was negatively associated with academic achievement in elementary and junior high school, after adjusting for key potential confounders. The control of lead poisoning should focus on primary prevention of lead exposure in children and development of special education programs for students with lead poisoning.

To maximize the reach and experience of high-need youth populations receiving sexual health education, state and local agencies should consider the importance of implementation setting. Targeted resources and efforts should be directed toward high-need young people by expanding beyond traditional school settings.