This case study addresses two major priorities of the Boston Foundation--health and education. Since the 2007 publication of the "Understanding Boston" report "The Boston Paradox: Lots of Health Care, Not Enough Health," the Boston Foundation has worked to draw attention to the epidemic of preventable chronic disease that not only threatens the health of Greater Boston's residents, but drives health care costs so high that they are crowding out investments in all other priorities, including prevention. In response, the Foundation launched the "Healthy People/Healthy Economy Coalition" in 2010--a broad group of business leaders, health care providers, public health advocates, and political and civic leaders--with the goal of making Massachusetts the national leader in health and wellness. While state law dictates that physical education should be a part of the curriculum in all schools, regulations no longer prescribe the amount of time students should spend in physical education classes. As of 2009, almost half of the Commonwealth's public school students were not participating in any physical education classes. In Boston, 30 percent of public schools offer no physical education classes at all. These statistics run counter to evidence-based guidelines that recommend at least 60 minutes of physical activity every day for youth, with at least 30 minutes occurring during the school day. Restoring physical activity to the school day is a crucial step in reducing childhood obesity and improving the overall health of our school-age children. A recent study by the Trust for America's Health gave Massachusetts the worst score in the country in a measure of physical activity among high school students. Only 17 percent of the state's high school students reported being physically active 60 minutes or more every day. Meanwhile, one in three children in the state is overweight or obese, a rate that has doubled over the last 15 years. These statistics should be seen in the context of national research, which has indicated that academic performance improves and behavioral problems decrease in schools where physical activity is incorporated into the school day. To begin exploring this issue in depth, the Boston Foundation engaged the Friedman School of Nutrition at Tufts University to conduct a study examining the impact of school-based physical activity, its relationship to academic outcomes, and whether such opportunities have equitable reach for diverse school children. The city of Lawrence is the focus of this report--a city that has been making great progress in their public education system in recent years. This report supports the Foundation's goal of reducing disparities in health outcomes--especially in the areas of obesity and obesity-related preventable chronic diseases. In the future, the Boston Foundation will build on this research by conducting a longitudinal study to track the longer-term effects of physical activity on reducing overweight and obesity rates as well as improving the health and academic outcomes of youth.