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United States Value:
Percentage of fourth grade public school students who scored proficient or above on the National Assessment of Educational Progress in reading comprehension
Explore Population Data:
Appears In:
Percentage of fourth grade non-Hispanic white public school students who scored proficient or above on the National Assessment of Educational Progress in reading comprehension
>= 44.5%
41.3% - 44.4%
38.3% - 41.2%
35.3% - 38.2%
<= 35.2%
US Value: 32.1%
Top State(s): Massachusetts: 42.6%
Bottom State(s): New Mexico: 21.0%
Definition: Percentage of fourth grade public school students who scored proficient or above on the National Assessment of Educational Progress in reading comprehension
Data Source and Years(s): U.S. Department of Education, National Center for Education Statistics, National Assessment of Educational Progress, 2022
Suggested Citation: America's Health Rankings analysis of U.S. Department of Education, National Center for Education Statistics, National Assessment of Educational Progress, United Health Foundation, AmericasHealthRankings.org, accessed 2024.
Fourth grade reading proficiency is an important indicator of adequate educational development. By the time a child reaches fourth grade, they are expected to be able to read in order to learn other academic subjects. If a child is not proficient in reading by this age, it becomes harder for them to succeed academically.
A 2011 landmark study found that children who are not reading proficiently by the end of third grade are much less likely to graduate from high school. Higher educational attainment is associated with better jobs, higher earnings, increased health knowledge, better self-reported health and fewer chronic conditions.
Several factors contribute to a child’s reading proficiency, including readiness for school, chronic absences, summer learning loss, family-related stressors and quality of teaching.
The National Assessment of Educational Progress uses cut points to determine proficiency levels. Fourth grade reading scores are higher among:
Research shows that providing young children with consistent language-rich experiences, such as talking, reading and singing, can positively impact brain development and future school success. Head Start programs promote school readiness and provide early learning opportunities for young children from low-income families.
County Health Rankings & Roadmaps lists several evidence-based strategies that improve reading outcomes, including:
Healthy People 2030 has a goal to increase the proportion of fourth graders with reading skills at or above the proficient level for their grade.
“2019 Kids Count Data Book State Trends in Child Well-Being.” Baltimore, Maryland: The Annie E. Casey Foundation, 2019. https://assets.aecf.org/m/resourcedoc/aecf-2019kidscountdatabook-2019.pdf#page=32.
Donald J. Hernandez. “Double Jeopardy How Third-Grade Reading Skills and Poverty Influence High School Graduation.” The Annie E. Casey Foundation, 2011. https://files.eric.ed.gov/fulltext/ED518818.pdf.
Ferguson, Laurie Anne, and Roberta Pawlak. “Health Literacy: The Road to Improved Health Outcomes.” The Journal for Nurse Practitioners 7, no. 2 (February 2011): 123–29. https://doi.org/10.1016/j.nurpra.2010.11.020.
Leila Fiester. “Early Warning Confirmed.” The Annie E. Casey Foundation, 2013. https://assets.aecf.org/m/resourcedoc/AECF-EarlyWarningConfirmed-2013.pdf#page=18.
Lundborg, Petter. “The Health Returns to Schooling—What Can We Learn from Twins?” Journal of Population Economics 26, no. 2 (2013): 673–701. https://doi.org/10.1007/s00148-012-0429-5.
“Why Education Matters to Health: Exploring the Causes.” Issue Brief #2. Education and Health Initiative. Richmond, VA: The VCU Center on Society and Health and Robert Wood Johnson Foundation, April 2014. https://societyhealth.vcu.edu/media/society-health/pdf/test-folder/CSH-EHI-Issue-Brief-2.pdf.
America’s Health Rankings builds on the work of the United Health Foundation to draw attention to public health and better understand the health of various populations. Our platform provides relevant information that policymakers, public health officials, advocates and leaders can use to effect change in their communities.
We have developed detailed analyses on the health of key populations in the country, including women and children, seniors and those who have served in the U.S. Armed Forces, in addition to a deep dive into health disparities across the country.