Research in Health Economics indicates that introducing school grades—with A as the highest grade and F as a failing grade—at younger ages may negatively affect children’s mental health.
In Sweden, students traditionally received individual grades beginning in eighth grade (around 14 years of age), but in the fall of 2012, a reform shifted the introduction of grades to sixth grade (around age 12).
By comparing sociodemographic and clinical data on 524,093 children in Sweden in grades 5 through 9 before and after the reform, investigators found that girls exposed to earlier grading were more likely to be diagnosed with internalizing disorders, such as depression and anxiety, by the end of compulsory school—especially female students with low to moderate academic achievement.
Evidence also suggested that both girls and boys exposed to earlier grading face an increased risk of being diagnosed with alcohol‐related disorders.
“Like many countries, Sweden has moved toward more testing and tighter grading, repeatedly revising its assessment system,” said corresponding author Anna Linder, PhD, of Lund University, in Sweden. “Our results show that these changes can have detrimental effects on children's mental health. Grades aren’t inherently harmful, but their design should carefully consider that children vary in when—and how—they can turn feedback into healthy growth.”
URL upon publication: https://onlinelibrary.wiley.com/doi/10.1002/hec.4982
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Health Economics is an international health policy journal publishing articles on all aspects of global health economics. We welcome theoretical contributions, empirical studies, and analyses of health policy from the economic perspective. With a wide scope, Health Economics welcomes contributions on the valuation, determinants and definition of health, health care supply and demand, planning and market mechanisms, treatment micro-economics, and health care system performance.
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Journal
Health Economics
DOI
Article Title
Adolescent Mental Health: Impact of Introducing Earlier Compulsory School Grades
Article Publication Date
9-Jul-2025