The incidence of environmentally related illnesses, such as tuberculosis, asthma, allergies, respiratory disease, depression, and violent anger is increasing, particularly in the inner cities. The effects of these illnesses is often overlooked in discussions of educational and social inequity. This article discusses the significance of this increase in disease with regard to the welfare of children and the impact on their academic achievement, due to physical and mental impairments. Information is provided about the causes, consequences, and rates of incidence of tuberculosis, lead poisoning and asthma. The article comments on the ways in which society and the schools have responded to these illnesses, and then considers the context of discussion about these illnesses and the social response to them. The article notes that, often, these illnesses are considered an affliction of the poor. The article issues a challenge for school reform that addresses environmentally induced damage to children as an educational issue, as well as a social one. Contains 44 references. (JPB)