A new study by John Jerrim, recently published in the Oxford Review of Education, examines a group often described as the “low-hanging fruit” for social mobility: high-achieving children from disadvantaged families. These are the young people who, against the odds, start school doing better than many of their more privileged peers. The assumption has long been that if anyone can “make it,” it’s them. However, adolescence seems to be a particularly perilous turning point.
What the Data Show
Drawing on England’s linked education and health records (ECHILD), Jerrim tracked hospital admissions of more than 42,000 high-achieving pupils born in the early 2000s. The focus was not on mild symptoms, but on serious cases that led to hospitalisation for mental health problems, self-harm, substance use, eating disorders, or pregnancy.
The findings are stark: by age 20, about 80 in every 1,000 high-achieving students from disadvantaged backgrounds had been hospitalised for such reasons, compared with 40 in every 1,000 of their equally able but more affluent peers. In other words, the risk is roughly doubled. For pregnancy, the gaps are even larger—high-achieving girls from poorer families were ten times more likely to have a hospital record related to childbirth than those from affluent backgrounds.
A Familiar Pattern in a New Domain
Education researchers have long documented that high-achieving disadvantaged pupils tend to “fall behind” during secondary school. Crawford et al. (2017), for example, showed how the gap in GCSE results widens sharply in early adolescence. What this study adds is evidence that health crises, especially mental health and behaviour-related issues, follow a similar trajectory. The same period—Years 9 and 10, around ages 13–15—emerges as particularly risky.
The implication is sobering: it’s not only about grades. The challenges that disadvantaged young people face during adolescence impact their health, well-being, and life chances. Falling behind academically may be entangled with deteriorating health.
Strengths and Caveats
There are good reasons to take these findings seriously. The sample size is unprecedented, and the use of administrative data helps mitigate many of the biases associated with small surveys. But the study also has limits. Hospital records only capture the most severe cases. Many more young people struggle with mental health or risky behaviour without ever appearing in hospital data. In that sense, the figures are likely the tip of the iceberg.
Another caveat: “high achievement” was defined by Key Stage 2 test scores at age 11. That’s a reasonable proxy, but, as always, it measures only part of children’s abilities. And while Jerrim takes care to address statistical artefacts like regression to the mean, the estimates—particularly those related to pregnancy—come with uncertainty.
Beyond Academics
What stands out is how early the divergence begins. By the start of secondary school, hospitalisation rates are already higher for disadvantaged pupils, and the gap widens quickly. The conclusion seems unavoidable: supporting these young people requires more than academic interventions. Schools, health services, and social care must work together.
This is, of course, easier said than done. But ignoring the problem comes with a cost—not just to the individuals who see their potential derailed, but to society as a whole. If the “bright poor kids” cannot thrive, social mobility remains a slogan rather than a reality.
Abstract of the study:
High-achieving children from disadvantaged backgrounds are an important group for promoting social mobility. Prior research has found their educational achievement does not keep pace with their more socio-economically advantaged peers during secondary school, with early adolescence identified as a key period when their academic potential starts to go unfulfilled. This paper presents new evidence on the health outcomes of this group during this period, focusing on mental health and behaviour-related hospital admissions. We find high-achieving children from disadvantaged backgrounds are hospitalised due to mental health and behaviour-related issues at a rate of around 80 per 1,000 children between the ages of 11 and 20. This is significantly above the rate of around 40 per 1,000 children for their equally able but more socio-economically advantaged peers. Our results hence provide further evidence that early adolescence is a key period during which high-achieving children from disadvantaged backgrounds require further support.