Because teenagers contribute litle to the economy, the loss of productivity was not noticeable until the middle of the 1970's when the students with the declining test scores started entering the labor force. The major impact of declining test scores came in the 1980's. There should have been greater productivity growth because of favorable economic conditions, but it didn't happen. The lack of adequately trained personnel for high paying jobs will continue to increase until at least the year 2010. The indirect cost may be even greater.
Underachievers are more likely to live on welfare and get into trouble with the law.
This cannot be attributed to the doors being opened to larger numbers of students. This decline is affecting all branches of medicine. A smaller proportion of medical students are interested in pursuing a career in internal medicine. The Journal of the American Dental Association has published cover stories on dental fluorosis, but the choice of offically recognized effects is limited and they still think that fluorosis is something that can be controlled by dentists as managers of their patient's dental health. The American Pediatrics Society has warned pediatricians that fluoride supplements for young children should be carefully controlled.