This study explores whether the interplay of health problems and school environment predicts academic failure, an individual event with consequences for the life course, as well as for society at large. This exploration proceeds in three steps: 1) we examine whether physical and mental health problems are an academic risk factor during secondary school; 2) we investigate the academic mechanisms underlying this risk status; and 3) we explore whether this risk status varies by school context. A series of logistic regressions reveals that self-rated health and emotional distress are both associated with greater likelihood of failing one or more classes in the next year and that absenteeism, trouble with homework, and student-teacher bonding account for much of these associations. Associations of physical and mental health problems with academic failure vary only slightly across schools, however. We discuss the implications of these findings for both research and policy and argue that the examination of overlap among different domains of adolescent functioning can advance the sociological understanding of health, education, and social problems in general.Academic performance, including academic failure, is often viewed in narrow terms, as an individual behavior limited to the early life course. However, academic performance has implications that play out across life stages and on multiple levels. On the individual level, academic struggles predict short-term problem behavior and dropout, and can derail educational and occupational trajectories well into adulthood (Crosnoe 2002b;Miller 1998;Rosenbaum, DeLuca, and Miller 1999). On the institutional level, academic problems among students can create disorder and undermine the general mission of schools (Steinberg, Brown, and Dornbusch 1996). On the population level, widespread academic failure influences rates of fertility, mortality, marriage, and unemployment through its relation to educational attainment and the development of human capital (Becker 1962;Mirowsky and Ross 2003b;Wilson 1978). Thus, what appears merely to be an aspect of the adolescent experience actually has far-reaching consequences across a variety of social phenomena.Educational research has identified numerous family, peer, and economic factors that contribute to academic failure (Schneider and Coleman 1993;Steinberg et al. 1996). Often lost in this inquiry, however, is consideration of physical and mental health problems for academic performance in secondary school. The relative lack of attention to health is unfortunate given that related literatures strongly suggest the possibility that health problems disrupt academic functioning. For example, research on adult populations has shown that mental and physical health problems negatively affect work performance (Dewa and Lin 2000). This study suggests that performance in the educational system-the social institution most directly equivalent to the labor force for adolescents-is also likely affected by health problems. Moreover, small-
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