The scores of the Scholastic Aptitude Test (SAT) have been declining since 1963. While this decline has occurred, scores on achievement tests administered to students in grades 3 to 11 have been stable. An alalysis of the medical and epidemiological literature was conducted to determine whether there could be a health factor that might have caused this situation. Nutrition, drugs, genetic and prenatal conditions, labor and delivery, child development, health status, and health care over several decades in the United States were reviewed. It was concluded that the decline in SAT scores has probably not resulted from disease or from the physical environment. A number of bibliographical references are appended. (Author/EVH)